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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

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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.

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Authors and Affiliations

  1. Geriatric Unit, Internal Medicine Department, Universitary Hospital Bellvitge-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain

    Francesc Formiga, Rafael Moreno-Gonzalez, David Chivite, Abelardo Montero & Xavier Corbella

  2. Internal Medicine Service, Hospital Universitari Quiron Dexeus, Barcelona, Spain

    Jonathan Franco

  3. Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain

    Xavier Corbella

Authors
  1. Francesc Formiga
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  2. Rafael Moreno-Gonzalez
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  3. David Chivite
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  4. Jonathan Franco
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  5. Abelardo Montero
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  6. Xavier Corbella
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Corresponding author

Correspondence to Francesc Formiga.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Statement of human and animal rights

The study has been approved by the ethics committee of the Bellvitge hospital.

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Formiga, F., Moreno-Gonzalez, R., Chivite, D. et al. 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. Aging Clin Exp Res 30, 927–933 (2018). https://doi.org/10.1007/s40520-017-0853-1

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  • DOI: https://doi.org/10.1007/s40520-017-0853-1

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