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Poor comprehensive geriatric assessment linked to long-term mortality in older HF patients
A poor score on a comprehensive geriatric assessment was associated with higher rates of long-term mortality among older patients hospitalized with HF, researchers reported in a new study.
Previous research has demonstrated a correlation between poor comprehensive geriatric assessment and worse prognosis during hospitalization for HF and soon after discharge. However, researchers said the correlation with long-term mortality was uncertain.
The new prospective study included 487 patients aged at least 75 years who were admitted to a hospital in Spain for a first or recurrent episode of decompensated HF. The patients were discharged alive between Oct. 1, 2006, and Sept. 30, 2009, and followed for 2 years after discharge.
A comprehensive geriatric assessment score was calculated for each patient upon discharge. The score was based on limitation in activities of daily living, comorbidity, mobility, cognitive decline and previous medication use, according to the study. Researchers examined the relationship between comprehensive geriatric assessment score and mortality rate during the 2-year follow-up period using Cox regression and adjusting for confounders.
Results revealed a 19% higher mortality (HR=1.19; 95% CI, 1.11-1.27) associated with each 1-point increase in comprehensive geriatric assessment score. This association persisted after the researchers adjusted for age, sex, left ventricular ejection fraction, atrial fibrillation, ischemic heart disease and other comorbidities.
The increased risk for mortality was consistent across all components of the comprehensive geriatric assessment score. According to the results, the HR for mortality was:
- 1.78 (95% CI, 1.25-2.54) for patients with three or more limitations in daily life vs. no limitations.
- 1.36 (95% CI, 1-1.86) for patients with moderate to severe limitations vs. no or mild limitations.
- 1.98 (95% CI, 1.29-3.03) for patients with a Charlson index score of 5 or more vs. 1 or less.
- 2.48 (95% CI, 1.84-3.34) for patients with previous cognitive decline vs. no previous cognitive decline.
- 1.77 (95% CI, 0.99-3.18) for patients who used eight or more medications vs. three or fewer medications.
“Our results have some practical implications,” the researchers wrote. “Although a full [comprehensive geriatric assessment] can only be performed in selected patients by multidisciplinary teams, data for the [comprehensive geriatric assessment] used in this study can be collected in less than 5 minutes in the emergency room or in the medical ward.”
Disclosure: The researchers report no relevant financial disclosures.