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Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases.
Heart. 2011 Oct; 97(19):1602-6.H

Abstract

OBJECTIVE

To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases.

DESIGN

Observational prospective study with 12-month clinical and functional follow-up.

SETTING

Clinical cardiology unit of a university hospital in Madrid, Spain.

PATIENTS

Consecutive patients ≥75 years old urgently admitted to the cardiology unit.

INTERVENTION

Systematic comprehensive geriatric assessment.

MAIN OUTCOME MEASURES

12-month rates of mortality, readmission, functional decline and need for new social help.

RESULTS

Among the 211 patients studied, 127 (60.2%) presented at least one MGS on admission: 86 frailty (40.8%), 67 cognitive impairment (31.8%), 31 severe dependency (14.7%) and 9 depression (4.3%). Patients with MGSs were slightly older (82±5 vs 81±4 years, p=0.02) but did not show greater disease severity or comorbidity. The presence of MGSs was associated with a higher incidence of functional decline during hospitalisation (35.7% vs 8.6%, p=0.002) and higher 12-month age-, comorbidity- and diagnosis-adjusted risks of readmission (OR, 2.1.92; 95% CI 0.98 to 3.7), functional decline (OR, 2.86; 95% CI 1.41 to 5.79) and need for new social help (OR, 3.10; 95% CI 1.45 to 6.60). MGSs were also associated with a higher 12-month mortality rate, which was only obvious in patients hospitalised for heart failure but not for other reasons.

CONCLUSIONS

A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure.

Authors+Show Affiliations

Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21795299

Citation

Sánchez, Elísabet, et al. "Prevalence of Geriatric Syndromes and Impact On Clinical and Functional Outcomes in Older Patients With Acute Cardiac Diseases." Heart (British Cardiac Society), vol. 97, no. 19, 2011, pp. 1602-6.
Sánchez E, Vidán MT, Serra JA, et al. Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases. Heart. 2011;97(19):1602-6.
Sánchez, E., Vidán, M. T., Serra, J. A., Fernández-Avilés, F., & Bueno, H. (2011). Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases. Heart (British Cardiac Society), 97(19), 1602-6. https://doi.org/10.1136/hrt.2011.227504
Sánchez E, et al. Prevalence of Geriatric Syndromes and Impact On Clinical and Functional Outcomes in Older Patients With Acute Cardiac Diseases. Heart. 2011;97(19):1602-6. PubMed PMID: 21795299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases. AU - Sánchez,Elísabet, AU - Vidán,María T, AU - Serra,José A, AU - Fernández-Avilés,Francisco, AU - Bueno,Héctor, Y1 - 2011/07/27/ PY - 2011/7/29/entrez PY - 2011/7/29/pubmed PY - 2011/11/1/medline SP - 1602 EP - 6 JF - Heart (British Cardiac Society) JO - Heart VL - 97 IS - 19 N2 - OBJECTIVE: To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases. DESIGN: Observational prospective study with 12-month clinical and functional follow-up. SETTING: Clinical cardiology unit of a university hospital in Madrid, Spain. PATIENTS: Consecutive patients ≥75 years old urgently admitted to the cardiology unit. INTERVENTION: Systematic comprehensive geriatric assessment. MAIN OUTCOME MEASURES: 12-month rates of mortality, readmission, functional decline and need for new social help. RESULTS: Among the 211 patients studied, 127 (60.2%) presented at least one MGS on admission: 86 frailty (40.8%), 67 cognitive impairment (31.8%), 31 severe dependency (14.7%) and 9 depression (4.3%). Patients with MGSs were slightly older (82±5 vs 81±4 years, p=0.02) but did not show greater disease severity or comorbidity. The presence of MGSs was associated with a higher incidence of functional decline during hospitalisation (35.7% vs 8.6%, p=0.002) and higher 12-month age-, comorbidity- and diagnosis-adjusted risks of readmission (OR, 2.1.92; 95% CI 0.98 to 3.7), functional decline (OR, 2.86; 95% CI 1.41 to 5.79) and need for new social help (OR, 3.10; 95% CI 1.45 to 6.60). MGSs were also associated with a higher 12-month mortality rate, which was only obvious in patients hospitalised for heart failure but not for other reasons. CONCLUSIONS: A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure. SN - 1468-201X UR - https://www.unboundmedicine.com/medline/citation/21795299/Prevalence_of_geriatric_syndromes_and_impact_on_clinical_and_functional_outcomes_in_older_patients_with_acute_cardiac_diseases_ L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=21795299 DB - PRIME DP - Unbound Medicine ER -