Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Prognosis of acute heart failure in patients followed up in nursing homes in Spa...
Journal Information
Vol. 162. Issue 4.
Pages 157-162 (February 2024)
Share
Share
Download PDF
More article options
Vol. 162. Issue 4.
Pages 157-162 (February 2024)
Original article
Prognosis of acute heart failure in patients followed up in nursing homes in Spain: Results from the RICA registry
Impacto pronóstico en la supervivencia de los pacientes en residencias de ancianos con insuficiencia cardiaca en España: Resultados del Registro RICA
Manuel Méndez-Bailona, Noel Lorenzo-Villalbab,
Corresponding author
noellorenzo@gmail.com

Corresponding author.
, Francisco Epelde-Gonzáloc, Pau Llàcerd, Alicia Conde-Martele, Luis Manzano-Espinosaf, José Carlos Arévalo-Loridog, Joan Carles Trullásh, Jesús Casado-Cerradai, Manuel Montero-Pérez-Barqueroj
a Internal Medicine, University Hospital Clinico San Carlos, Facultad de Medicina, Universidad Complutense, IdISSC, Madrid, Spain
b Service de Médecine Interne, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
c USU, Hospital Universitari Parc Taulí, Barcelona, Spain
d Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
e Internal Medicine, University Hospital of Gran Canaria (Dr. Negrín), Spain
f Internal Medicine, University Hospital Ramón y Cajal, Madrid, Spain
g Internal Medicine, University Hospital of Badajoz, Spain
h Internal Medicine Department, Hospital d’Olot, Girona, Catalonia, Spain
i Internal Medicine, University Hospital of Getafe, Madrid, Spain
j Internal Medicine, IMIBIC, University Hospital “Reina Sofía”, Córdoba, Spain
Ver más
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (4)
Table 1. Baseline characteristics of patients with HF according to caregiver.
Table 2. Outcomes of patients with HF according to care setting.
Table 3. Univariate and multivariate Cox analysis of risk for 1-year mortality.
Table 4. Univariate and multivariate Cox analysis of risk for 1-year readmission.
Show moreShow less
Abstract
Background

Patients with chronic diseases such as heart failure (HF) are at risk of hospital admission. We evaluated the impact of living in nursing homes (NH) on readmissions and all-cause mortality of HF patients during a one-year follow up.

Methods

An observational and multicenter study from the Spanish National Registry of Heart Failure (RICA) was performed. We compared clinical and prognostic characteristics between both groups. Bivariate analyses were performed using Student's t-test and Tukey's method and a Kaplan–Meier survival at one-year follow up. A multivariate proportional hazards analysis of [Cox] regression by the conditional backward method was conducted for the variables being statistically significant related to the probability of death in the univariate.

Results

There were 5644 patients included, 462 (8.2%) of whom were nursing home residents. There were 52.7% women and mean age was 79.7±8.8 years. NH residents had lower Barthel (74.07), Charlson (3.27), and Pfeiffer index (2.2), p<0.001). Mean pro-BNP was 6686pg/ml without statistical significance differences between groups. After 1-year follow-up, crude analysis showed no differences in readmissions 74.7% vs. 72.3%, p=0.292, or mortality 63.9% vs. 61.1%, p=0.239 between groups. However, after controlling for confounding variables, NH residents had a higher 1-year all-cause mortality (HR 1.153; 95% CI 1.011–1.317; p=0.034). Kaplan–Meier analysis showed worse survival in nursing home residents (log-rank of 7.12, p=0.008).

Conclusions

Nursing home residents with heart failure showed higher one-year mortality which could be due to worse functional status, higher comorbidity, and cognitive deterioration.

Keywords:
Heart failure
Nursing home resident
Mortality
Resumen
Introducción

Los pacientes con enfermedades crónicas como la insuficiencia cardiaca (IC) presentan mayor riesgo de ingreso. Se evaluó el impacto sobre los reingresos y la mortalidad por todas las causas de los pacientes con IC respecto a vivir o no en residencias de ancianos durante un año de seguimiento.

Métodos

Estudio observacional y multicéntrico a partir del Registro Nacional de Insuficiencia Cardiaca (RICA). Se compararon las características clínicas y pronósticas entre ambos grupos. Se realizó un análisis bivariante mediante el método de t de Student y Tukey y un análisis de supervivencia mediante Kaplan-Meier al año de seguimiento, así como un análisis multivariante de riesgos proporcionales de regresión (Cox) por el método de retroceso condicional para las variables que se relacionaban de forma estadísticamente significativa con la probabilidad de muerte en el univariante.

Resultados

Fueron incluidos 5.644 pacientes; 462 (8,2%) de ellos estaban en residencias, el 52,7% eran mujeres y la edad media era de 79,7±8,8 años. Los pacientes en residencias tenían menor Barthel (74,07), Charlson (3,27) y Pfeiffer (2,2) (p<0,001). El pro-BNP medio era de 6.686 pg/ml sin diferencias significativas. Tras un año de seguimiento, el análisis bruto no mostró diferencias en los reingresos (74,7 vs. 72,3%; p=0,292) ni en mortalidad (63,9 vs. 61,1%; p=0,239) entre ambos grupos. Tras controlar las variables de confusión, los pacientes en residencias presentaron una mayor mortalidad por todas las causas a un año (hazard ratio 1,153; IC 95%: 1,011-1,317; p=0,034) así como peor supervivencia en el análisis de Kaplan-Meier (log-rank 7,12; p=0,008).

Conclusiones

Los pacientes con IC en residencias de ancianos mostraron una mayor mortalidad a un año, que podría deberse a un peor estado funcional, a mayor deterioro cognitivo y a más comorbilidad.

Palabras clave:
Insuficiencia cardiaca
Residente en hogar de ancianos
Mortalidad

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos