PMID- 24452223 OWN - NLM STAT- MEDLINE DCOM- 20141223 LR - 20140219 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 172 IP - 1 DP - 2014 Mar 1 TI - Basal functional status predicts three-month mortality after a heart failure hospitalization in elderly patients - the prospective RICA study. PG - 127-31 LID - S0167-5273(14)00029-1 [pii] LID - 10.1016/j.ijcard.2013.12.169 [doi] AB - BACKGROUND: Many elderly heart failure (HF) patients show some degree of functional impairment. The study aim was to evaluate the functional status of oldest-old cohort of patients hospitalized with a diagnosis of decompensated (HF), and to analyze whether preadmission functional status predicts risk of 3-month mortality. METHODS: We analyzed 1431 elderly (>/= 75 years) patients prospectively included in the Spanish National Registry on HF (RICA). We added Barthel Index (BI) to the usual HF patient assessment to measure patients' functional status, and we evaluated the relationship between preadmission BI values and 3-month mortality. RESULTS: The mean age of patients was 82.3 (4.6) years. Patients' mean preadmission BI score was 81.3 (21.5); 802 patients (55.9%) had BI scores <61. Multivariate analysis confirmed an independent association between poor preadmission BI and older age, female sex, higher comorbidity, cognitive impairment, previous institutionalization, worse New York Heart Association (NYHA) functional class and lack of beta-blocker use. A total of 210 patients died (14.7%) after 3 months of follow-up. Cox multivariate analyses found that higher preadmission BI is correlated with reduced all-cause, 3-month postdischarge mortality [hazard ratio (HR) 0.981; CI95% 0.975-0.986, p<0.001]. Other variables independently associated with 3-month mortality were male sex, lower body mass index, lower systolic blood pressure, a diagnosis of diabetes and chronic kidney disease, worse NYHA class and not receiving treatment with beta-blockers. CONCLUSIONS: Severe functional disability is present among more than half of older patients admitted because of a HF decompensation. For this population, preadmission BI is a strong predictor of short-term mortality. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - Formiga, Francesc AU - Formiga F AD - Geriatric Unit, Internal Medicine Service, IDIBELL, Hospital Universitari de Bellvitge, L Hospitalet de Llobregat, Barcelona, Spain. Electronic address: fformiga@bellvitgehospital.cat. FAU - Chivite, David AU - Chivite D AD - Geriatric Unit, Internal Medicine Service, IDIBELL, Hospital Universitari de Bellvitge, L Hospitalet de Llobregat, Barcelona, Spain. FAU - Conde, Alicia AU - Conde A AD - Internal Medicine Department, Hospital Universitario de Gran Canaria Dr. Negrin, Universidad de Las Palmas de Gran Canaria, Spain. FAU - Ruiz-Laiglesia, Fernando AU - Ruiz-Laiglesia F AD - Internal Medicine Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain. FAU - Franco, Alvaro Gonzalez AU - Franco AG AD - Internal Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain. FAU - Bocanegra, Carmen Perez AU - Bocanegra CP AD - Internal Medicine Department, Hospital Universitario Vall d Hebron, Barcelona, Spain. FAU - Manzano, Luis AU - Manzano L AD - Heart Failure and Vascular Risk Unit, Internal Medicine Department, Hospital Universitario Ramon y Cajal, Universidad de Alcala, Madrid, Spain. FAU - Perez-Barquero, Manuel Montero AU - Perez-Barquero MM AD - Internal Medicine Department, IMBIC/Hospital Reina Sofia, Universidad de Cordoba, Spain. CN - RICA Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140108 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Female MH - Follow-Up Studies MH - Heart Failure/*diagnosis/*mortality MH - Heart Function Tests/*statistics & numerical data MH - Hospitalization MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Medical Staff, Hospital/statistics & numerical data MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Prospective Studies OTO - NOTNLM OT - Barthel Index OT - Elderly OT - Functional status OT - Heart failure OT - Mortality FIR - Anarte, L IR - Anarte L FIR - Aramburu, O IR - Aramburu O FIR - Arevalo, J C IR - Arevalo JC FIR - Arias, J L IR - Arias JL FIR - Armengou, A IR - Armengou A FIR - Bas-Sanchis, F IR - Bas-Sanchis F FIR - Bettencourt, P IR - Bettencourt P FIR - Carrasco, F J IR - Carrasco FJ FIR - Carrera, M IR - Carrera M FIR - Casado, J IR - Casado J FIR - Ceresuela, L M IR - Ceresuela LM FIR - Cerqueiro, J M IR - Cerqueiro JM FIR - Chivite, D IR - Chivite D FIR - Conde, A IR - Conde A FIR - Davila, M F IR - Davila MF FIR - Diez-Manglano, J IR - Diez-Manglano J FIR - Epelde, F IR - Epelde F FIR - Formiga, F IR - Formiga F FIR - Franco, J IR - Franco J FIR - Gonzalez-Franco, A IR - Gonzalez-Franco A FIR - Gonzalez, A IR - Gonzalez A FIR - Grau-Amoros, J IR - Grau-Amoros J FIR - Oropesa, R IR - Oropesa R FIR - Perez-Bocanegra, C IR - Perez-Bocanegra C FIR - Perez-Calvo, J I IR - Perez-Calvo JI FIR - Quesada, M A IR - Quesada MA FIR - Quiros, R IR - Quiros R FIR - Llacer, P IR - Llacer P FIR - Manzano, L IR - Manzano L FIR - Montero, M IR - Montero M FIR - Morales, J L IR - Morales JL FIR - Muela, A IR - Muela A FIR - Murado, I IR - Murado I FIR - Recio, J IR - Recio J FIR - Roca, B IR - Roca B FIR - Ruiz, R IR - Ruiz R FIR - Ruiz-Laiglesia, F IR - Ruiz-Laiglesia F FIR - Trullas, J C IR - Trullas JC FIR - Sanchez-Marteles, M IR - Sanchez-Marteles M FIR - Sanchez, C IR - Sanchez C FIR - Serrado, A IR - Serrado A FIR - Suarez, I IR - Suarez I FIR - Urrutia, A IR - Urrutia A EDAT- 2014/01/24 06:00 MHDA- 2014/12/24 06:00 CRDT- 2014/01/24 06:00 PHST- 2013/09/08 00:00 [received] PHST- 2013/12/13 00:00 [revised] PHST- 2013/12/30 00:00 [accepted] PHST- 2014/01/24 06:00 [entrez] PHST- 2014/01/24 06:00 [pubmed] PHST- 2014/12/24 06:00 [medline] AID - S0167-5273(14)00029-1 [pii] AID - 10.1016/j.ijcard.2013.12.169 [doi] PST - ppublish SO - Int J Cardiol. 2014 Mar 1;172(1):127-31. doi: 10.1016/j.ijcard.2013.12.169. Epub 2014 Jan 8.