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Title: Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study
Author: Muñoz, Miguel Angel
Calero, Esther
Duran, Julio
Navas, Elena
Alonso, Susana
Argemí, Nuria
Casademunt, Marta
Furió, Patricia
Casajuana, Elena
Torralba, Nuria
Farre, Nuria
Abellana Sangrà, Rosa Mari
Verdú Rotellar, Jose Maria
Keywords: Insuficiència cardíaca
Pronòstic mèdic
Heart failure
Issue Date: 19-Apr-2022
Publisher: MDPI
Abstract: Background: Information regarding short-term vital prognosis in patients with heart failure at advanced stages of the disease is scarce. Objective: To develop a three-month mortality predictive model for patients with advanced heart failure. Methods: Prospective observational study carried out in primary care and a convalescence community facility. Heart failure patients either New York Heart Association (NYHA) III with at least two HF hospitalizations during the previous six months or NYHA IV with/without previous recent hospitalization were included in the study. Multivariable predictive models using Cox regression were performed. Results: Of 271 patients included, 55 (20.3%) died during the first three months of follow-up. Mean age was 84.2 years (SD 8.3) and 59.8% were women. Predictive model including NT-proBNP had a C-index of 0.78 (95% CI 0.71; 0.85) and identified male gender, low body mass index, high potassium and NT-proBNP levels, and moderate-to-severe dependence for daily living activities (Barthel index < 40) as risk factors of mortality. In the model without NT-proBNP, C index was 0.72 (95% CI 0.64; 0.79) and, in addition to gender, body mass index, low Barthel index, and severe reductions in glomerular filtration rate showed the highest predictive hazard ratios for short-term mortality. Conclusions: In addition to age, male gender, potassium levels, low body mass index, and low glomerular filtration, dependence for activities of daily living add strong power to predict mortality at three months in patients with advanced heart failure
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It is part of: Journal of Clinical Medicine, 2022, vol. 11, num. 9, p. 2280
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ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Fonaments Clínics)

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