title: Comorbidity in heart failure. Results of the Spanish RICA Registry.
abstract: BACKGROUND
  We sought to identify the comorbidities associated with heart failure (HF) in a non-selected cohort of patients, and its influence on mortality and rehospitalization.
  
  
  METHODS
  Data were obtained from the 'Registro de Insuficiencia Cardiaca' (RICA) of the Spanish Society of Internal Medicine. The registry includes patients prospectively admitted in Internal Medicine units for acute HF. Variables included in Charlson Index (ChI) were collected and analysed according to age, gender, left ventricular ejection fraction (LVEF) and Barthel Index. The primary end point of study was the likelihood of rehospitalization and death for any cause during the year after discharge.
  
  
  RESULTS
  We included 2051 patients, mean age 78 and 53% females. LVEF was ⩾ 50% in 59.1% of the cohort. There was a high degree of dependency as measured by Barthel Index (14.8 % had an index ≤ 60). Mean ChI was 2.91 (SD ± 2.4). The most frequent comorbidities included in ChI were diabetes mellitus (44.3%), chronic renal impairment (30.8%) and chronic obstructive pulmonary disease (COPD) (27.4%). Age, myocardial infarction, peripheral artery disease, dementia, COPD, chronic renal impairment and diabetes with target-organ damage were all identified as independent prognostic factors for the combined end point of rehospitalization and death at 1 year. However, if multivariate analysis was done including ChI, only this remained as an independent prognostic factor for the combined end point (P < 0.001).
  
  
  CONCLUSIONS
  HF is a comorbid condition. ChI is a simple and feasible tool for estimating the burden of comorbidities in such population. We believe that a holistic approach to HF would improve prognosis and the relief the pressure exerted on public health services.
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain fruizl@unizar.es.
authors.forename: F-J
authors.initials: FJ
authors.lastname: Ruiz-Laiglesia
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Marteles
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: J-I
authors.initials: JI
authors.lastname: Pérez-Calvo
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Formiga
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Bartolomé-Satué
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Armengou-Arxé
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: R
authors.initials: R
authors.lastname: López-Quirós
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pérez-Silvestre
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Serrado-Iglesias
authors.affiliation: From the Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Department of Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Department of Internal Medicine, Hospital Costa del Sol, Marbella Málaga, Department of Internal Medicine, Consorcio Hospital General Universitario de Valencia, Valencia, Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona and Department of Internal Medicine, IMIBIC/Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Montero-Pérez-Barquero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012042:Registries; D019233:Retreatment / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology