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Baldasseroni, Samuele; Virciglio, Simona; Herbst, Andrea; Camartini, Viola; Pratesi, Alessandra; Salucci, Caterina; Franci Montorsi, Riccardo; D'Errico, Giovanni; Verga, Francesca; Ungar, Andrea; Fattirolli, Francesco; Marchionni, Niccolò; Orso, Francesco
European geriatric medicine, 12/2022, Volume: 13, Issue: 6Journal Article
Consensus exits about the clinical benefits of an early referral to multidisciplinary Heart Failure Unit-HFU for old frail patients with HF. Nevertheless, few data are present regarding the prognosis and the predictors of outcome in oldest-old patients managed in this clinical setting. The aim of present study is to identify predictors of 1-year all-cause mortality in very old patients enrolled in our multidisciplinary HFU after an episode of acute decompensated HF. This study is a retro-prospective, single-center cohort analysis of patients managed in our multidisciplinary HFU. Inclusion criterion was diagnosis of HF according to ESC guidelines and age ≥ 85 years, while no exclusion criteria were pre-defined. Baseline clinical and comprehensive geriatric evaluations were recorded during the first visit and follow-up visits were repeated according to our standardized timetable protocol. Primary end-point was 1-year all-cause mortality. We enrolled 75 patients aged 89.2 ± 2.8 years; 39 (52.0%) were females. During 1-year follow-up, seventeen patients (22.7%) died. Residual congestion with higher level (> 4) of EVEREST score (HR 1.24: 95% CI 1.04-1.47) and living alone (HR 3.34: 95% CI 1.16-9.64) resulted the two independent predictors of 1-year all-cause mortality at the multivariate Cox regression model. Finally, patients living alone and with an EVEREST score > 4 experienced a worse prognosis as clearly described by a steeper descendent Kaplan-Meier curve. In a very old population of patients after an acute decompensated HF, residual congestion and social isolation as living alone identify those with high risk of 1-year death.
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