Geriatric Unit, Internal Medicine Department, Universitary Hospital Bellvitge-IDIBELL, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Internal Medicine Service, Hospital Universitari Quiron Dexeus, Barcelona, Spain.
Aging Clin Exp Res. 2018 Aug;30(8):927-933. doi: 10.1007/s40520-017-0853-1. Epub 2017 Nov 9.
Comorbidity is related to poor health results in chronic heart failure (HF).
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).
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.
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).
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.
合并症与慢性心力衰竭（HF）的不良健康结果有关。
本研究旨在评估首次因急性 HF（AHF）住院后的高 Charlson 合并症指数评分（CCI）是否与 1 年死亡率相关。
我们回顾了两年内因首次 AHF 发作而住院的 897 名年龄大于 65 岁的患者的病历。我们分析了两个组：低（CCI≤2）和高（CCI>2）合并症。
患者的平均 CCI 为 2.2±1.7；344 名患者（38.35%）CCI>2。高合并症组的 1 年全因死亡率为 32.6%，高于低合并症组患者（23.7%，p=0.002）。Cox 多变量分析确定 CCI>2 是 1 年死亡率的独立危险因素（p=0.002；HR：1.525；95%CI 1.161-2.003），同时还与年龄较大、动脉高血压病史以及较高的入院心率和血清钾值相关。分析 CCI 作为连续变量，关联仍然显著（p=0.0001；HR 1.145；95%CI 1.069-1.854）。
首次因 AHF 住院时更高的整体合并症（CCI>2）是老年 HF 患者出院后中期死亡率的独立预测因子。
