Université Paris Sud, Le Kremlin-Bicêtre, France.
APHP, Department of Cardiology, Hopital Bicêtre, 78, rue du général Leclerc, 94270, Le Kremlin Bicêtre, France.
BMC Geriatr. 2021 May 1;21(1):288. doi: 10.1186/s12877-021-02210-0.
A growing number of elderly patients hospitalized for Acute Heart Failure (AHF) are being managed in cardiogeriatrics departments, but their characteristics and prognosis are poorly known. This study aimed to investigate the profile and outcome (rehospitalization at 90 days) of patients hospitalized for AHF in cardiogeriatrics departments in the Val-de-Marne area in the suburbs of Paris, and to compare them to AHF patients hospitalized in cardiology departments in the same area.
Observational study, ICREX-94, conducted in seven cardiology departments in France and three specific cardiogeriatrics departments in Val-de-Marne.
A total of 308 patients were hospitalized for AHF between October 2017 and January 2019. During the 90 days following discharge, 29.6% patients were readmitted to the hospital. Compared with patients hospitalized in cardiology departments, patients in cardiogeriatrics departments were older (p < 0.001), less independent (living more often alone or in an institution) (p < 0.001), more often depressed (p < 0.001), had more often major neurocognitive disorder (p < 0.001), had a higher Human Development Index (HDI, p < 0.001), and were less often diagnosed with amyloidosis (p < 0.001). There was no difference in outcome whether patients were discharged from cardiology or cardiogeriatrics departments. The most frequent precipitating factors underlying AHF decompensation between the first and second hospitalization were arrhythmia and infection.
AHF patients discharged from cardiogeriatrics departments, compared to cardiology departments, showed clinical differences but had the same prognosis regarding AHF rehospitalization at 90 days.
越来越多因急性心力衰竭（AHF）住院的老年患者在心脏老年医学科接受治疗，但他们的特征和预后知之甚少。本研究旨在调查巴黎郊区瓦尔德马恩地区心脏老年医学科收治的 AHF 患者的特征和预后（90 天再入院），并将其与同一地区心内科收治的 AHF 患者进行比较。
这是一项在法国七家心内科和瓦尔德马恩地区三家特定心脏老年医学科进行的观察性研究，研究名称为 ICREX-94。
2017 年 10 月至 2019 年 1 月期间，共有 308 例患者因 AHF 住院。出院后 90 天内，29.6%的患者再次住院。与心内科收治的患者相比，心脏老年医学科收治的患者年龄更大（p<0.001），独立性较差（更经常独居或住在机构中）（p<0.001），更经常抑郁（p<0.001），更经常患有严重的神经认知障碍（p<0.001），人类发展指数（HDI）更高（p<0.001），且较少被诊断为淀粉样变性（p<0.001）。无论患者是从心内科还是心脏老年医学科出院，其预后均无差异。第一次和第二次住院时心力衰竭失代偿的最常见诱发因素是心律失常和感染。
与心内科相比，从心脏老年医学科出院的 AHF 患者表现出不同的临床特征，但在 90 天的 AHF 再入院方面具有相同的预后。
