Comorbidity drives mortality in newly diagnosed heart failure: a study among geriatric outpatients |
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Authors: | Oudejans Irène Mosterd Arend Zuithoff Nicolaas P Hoes Arno W |
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Institution: | Department of Geriatric Medicine, Elkerliek Hospital, Helmond, The Netherlands. ioudejans@elkerliek.nl |
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Abstract: | BackgroundElderly heart failure (HF) patients frequently have multiple comorbidities. The prognostic impact of combined comorbidities is poorly quantified in these patients. We assessed the impact of comorbidities on 3-year mortality in geriatric outpatients with newly diagnosed HF.Methods and ResultsOf 93 geriatric outpatients with HF (mean age 82.7 years, 36.6% men), 52 patients (55.9%) died within 3 years after HF was diagnosed. Comorbidity was measured with the Charlson Comorbidity Index (CCI). Age- and gender-adjusted hazard ratio (HR) for 3-year mortality was 1.6 (95% confidence interval CI] 0.9–3.2) for patients with 3–4 CCI points and 3.2 (95% CI 1.5–6.8) for those with >4 CCI points, compared with 1–2 CCI points. After adjustment for age, gender, left ventricular ejection fraction (LVEF), and N-terminal pro–B-type natriuretic peptide, CCI remained predictive of death (CCI 3–4: HR 1.5 (95% CI 0.7–2.9); CCI >4: HR 4.0 (95% CI 1.9–8.8)). In addition to age and gender, the c-statistics for CCI and LVEF were similar (0.63 95% CI 0.55–0.70] and 0.64 95% CI 0.56–0.72], respectively).ConclusionsThe majority of geriatric outpatients with new HF die within 3 years. Comorbidity, summarized in the CCI, is the strongest independent predictor of mortality. |
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