CO07 | Mortality and hospitalization predictors in over 65 years old patients 1 year after hospitalization for heart failure in Internal Medicine

F. Busetti¹, M. Bussolotto², P. Pujatti³, M. Cigolini⁴, G. Cardaci⁵, A.C. Frigo⁶, B. Girolami⁵, G. Baggio⁶, P. Simioni⁵ | ¹Geriatria, Ospedale di Piove di Sacco, (PD), ²Medicina Generale, Azienda Ospedale Università Padova, ³Ospedale di Comunità Relaxxi 3, Noale, (VE), ⁴Dipartimento di Medicina, Ospedale San Bonifacio, Verona, ⁵Clinica Medica I ad indirizzo trombotico emorragico, Università di Padova, ⁶Università di Padova, Italy

Abstract

Premises and Purpose of the study: Heart Failure (HF) significantly impacts on disability and mortality, especially among the elderly. Identifying easy predictors of adverse outcomes in patients discharged for HF from the hospital is relevant in improving follow up.
Materials and Methods: Over 65 years (y) old patients discharged with a 1st diagnosis of HF in Internal Medicine departments were eligible for a cohort study. Univariate and multivariate logistic regression analysis tested the impact of 19 variables, cardiovascular (CV) or not, on mortality or new hospitalization, due to overall or CV causes, after 1 y. Odds ratios (OR) with 95% Confidence Intervals (CI) were calculated.
Results: Out of 229 included patients, 52% were male; mean age was 82±7 y. 1 y after discharge, 62% of the patients were hospitalized while 29% died. Among 19 prognostic variables, Barthel Index <60 was significantly associated with overall (OR 6.8, 95% CI 2.9 to 15.8) or CV mortality (OR 3.7, 95% CI 1.6 to 8.4); CIRS (Cumulative Illness Rating Scale) resulted significantly associated with overall hospitalization (OR 2.6, 95% CI 1.4 to 4.7), overall (OR 5, 95% CI 1.3 to 18.8) or CV death (OR 4.7, 95% CI 1.02 to 21.2). Previous HF admissions, diabetes and anemia were significantly associated with hospitalization, not with mortality.
Conclusions: Over 65 y old patients discharged because of HF from Internal Medicine Departments improve their prognostic stratification by means of Internal Medicine scores which identify patients at higher risk of death (CIRS, Barthel) or hospitalization (CIRS) within 1 y.