Martín-Sánchez Francisco Javier, Rodríguez-Adrada Esther, Mueller Christian, Vidán María Teresa, Christ Michael, Frank Peacock W, Rizzi Miguel Alberto, Alquezar Aitor, Piñera Pascual, Aragues Paula Lázaro, Llorens Pere, Herrero Pablo, Jacob Javier, Fernández Cristina, Miró Òscar
Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
Acad Emerg Med. 2017 Mar;24(3):298-307. doi: 10.1111/acem.13124.
The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs).
The Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months. Frailty was defined by frailty phenotype as the presence of three or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients.
A total of 465 patients with a mean (±SD) age of 82 (±7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index ≥ 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted hazard ratio = 2.5; 95% confidence interval = 1.0 to 6.0; p = 0.047).
The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.
本研究旨在确定衰弱对急诊科就诊的非严重残疾老年急性心力衰竭（AHF）患者30天死亡率风险的影响。
衰弱-AHF研究是一项对多中心、观察性、前瞻性队列研究（老年AHF登记册）的回顾性分析。本研究纳入了西班牙三个急诊科连续4个月内就诊的≥65岁、无严重功能依赖或痴呆的AHF患者。衰弱由衰弱表型定义为存在三个或更多领域。收集了所有患者的基线和发作特征以及30天死亡率。
共纳入465例患者，平均（±标准差）年龄为82（±7）岁，其中283例（61.0%）为女性，225例（51.3%）有严重合并症（Charlson指数≥3）。169例（36.3%）存在衰弱。30天死亡率为7.3%。校正潜在混杂因素后的衰弱是与30天死亡率相关的独立因素（校正风险比=2.5；95%置信区间=1.0至6.0；p=0.047）。
在急诊科就诊的非严重依赖老年AHF患者中，衰弱的存在是30天死亡率的独立危险因素。
