Nardi R, Fiorino S, Borioni D, Agostini D, D'Anastasio C, Marchetti C, Muratori M
Azienda USL di Bologna, Dipartimento di Medicina Interna, Ospedale di Bazzano, Bazzano, Italy.
Arch Gerontol Geriatr. 2007;44 Suppl 1:279-88. doi: 10.1016/j.archger.2007.01.037.
Congestive heart failure (CHF) and cognitive impairment are both common problems in old age, associated with significant mortality, impaired quality of life and disability. This study evaluated patients with CHF, admitted to internal medicine and geriatric wards. We identified factors associated with a high risk of in-hospital mortality. Hospitalized CHF subjects with increased risk of in-hospital death present a clinical profile including: very old age, overt cognitive dysfunction, predisposition to falls, dependency, social-family problems, impairment in sphincter control and feeding ability, presence of bedsores, digoxin but not warfarin treatment, hypo-dysproteinemia and hypernatremia and mild renal impairment. We observed that patients admitted to our Internal Medicine Departments, in addition to CHF, present a high grade of complex therapeutic needs and that comorbidity, by itself, does not reflect complexity. Our data support the hypothesis that CHF has different patterns of severity and prognosis in young and in old or very old age groups.
充血性心力衰竭（CHF）和认知障碍都是老年人常见的问题，与高死亡率、生活质量受损和残疾相关。本研究评估了入住内科和老年病房的CHF患者。我们确定了与院内高死亡风险相关的因素。住院死亡风险增加的CHF患者具有以下临床特征：高龄、明显的认知功能障碍、跌倒倾向、依赖、社会家庭问题、括约肌控制和进食能力受损、存在褥疮、接受地高辛而非华法林治疗、低蛋白血症和高钠血症以及轻度肾功能损害。我们观察到，入住我们内科的患者除了患有CHF外，还存在高度复杂的治疗需求，而且合并症本身并不能反映复杂性。我们的数据支持这样一种假设，即CHF在年轻人和老年人或高龄人群中具有不同的严重程度模式和预后。
