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Aging Clin Exp Res. 2018 Aug;30(8):927-933. doi: 10.1007/s40520-017-0853-1. Epub 2017 Nov 9.

High comorbidity, measured by the Charlson Comorbidity Index, associates with higher 1-year mortality risks in elderly patients experiencing a first acute heart failure hospitalization.

Author information

1
Geriatric Unit, Internal Medicine Department, Universitary Hospital Bellvitge-IDIBELL, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. fformiga@bellvitgehospital.cat.
2
Geriatric Unit, Internal Medicine Department, Universitary Hospital Bellvitge-IDIBELL, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
3
Internal Medicine Service, Hospital Universitari Quiron Dexeus, Barcelona, Spain.
4
Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.

Abstract

BACKGROUND:

Comorbidity is related to poor health results in chronic heart failure (HF).

AIMS:

The purpose of the study was to assess whether a high Charlson Comorbidity Index score (CCI) relates to 1 year mortality after a first hospitalization for acute HF (AHF).

METHODS:

We reviewed the medical records of 897 patients > 65 years of age admitted within a two-year period because of a first episode of AHF. We analyzed two groups: low (CCI ≤ 2) and high (CCI > 2) comorbidity.

RESULTS:

Patients' mean CCI was 2.2 ± 1.7; 344 patients (38.35%) had a CCI > 2. 1-year all-cause mortality rate in the high comorbidity group was 32.6%, worse than that among low comorbidity group patients (23.7%, p = 0.002). Cox multivariate analysis identified a CCI > 2 as an independent risk factor for 1-year mortality (p = 0.002; HR: 1.525; CI 95% 1.161-2.003), along with older age, history of arterial hypertension, and higher admission heart rate and serum potassium values. Analyzing CCI as a continuous variable, the association remained is also significant (p = 0.0001; HR 1.145; CI 95% 1.069-1.854).

CONCLUSIONS:

Higher global comorbidity (CCI > 2) at the time of a first hospitalization because of AHF is an independent predictor of mid-term post-discharge mortality among elderly HF patients.

KEYWORDS:

Comorbidity; Heart failure; Hospitalization; Mortality

PMID:
29124524
DOI:
10.1007/s40520-017-0853-1
[Indexed for MEDLINE]

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