Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study
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 pr...
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MDPI AG
2022-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/9/2280 |
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| author | Miguel Angel Muñoz Esther Calero Julio Duran Elena Navas Susana Alonso Nuria Argemí Marta Casademunt Patricia Furió Elena Casajuana Nuria Torralba Nuria Farre Rosa Abellana José-Maria Verdú-Rotellar On behalf of HADES Study |
| author_facet | Miguel Angel Muñoz Esther Calero Julio Duran Elena Navas Susana Alonso Nuria Argemí Marta Casademunt Patricia Furió Elena Casajuana Nuria Torralba Nuria Farre Rosa Abellana José-Maria Verdú-Rotellar On behalf of HADES Study |
| author_sort | Miguel Angel Muñoz |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T04:02:19Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:02:19Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-553506de8a394ece9e5d2e2518669a962023-11-23T08:30:03ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01119228010.3390/jcm11092280Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades StudyMiguel Angel Muñoz0Esther Calero1Julio Duran2Elena Navas3Susana Alonso4Nuria Argemí5Marta Casademunt6Patricia Furió7Elena Casajuana8Nuria Torralba9Nuria Farre10Rosa Abellana11José-Maria Verdú-Rotellar12On behalf of HADES StudyGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainBellvitge University Hospital, Institut Català de la Salut, 08921 Barcelona, SpainClinica Sant Antoni (Institut Medic i de Rehabilitació), 08038 Barcelona, SpainInstitut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainHospital del Mar Medical Research Institute, 08003 Barcelona, SpainDepartament de Fonaments Clínics-Bioestadística, School of Medicine, Universitat de Barcelona, 08007 Barcelona, SpainGerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, 08007 Barcelona, SpainBackground: 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.https://www.mdpi.com/2077-0383/11/9/2280heart failurecommunity settingpredictive modelmortalityshort term prognosisend of life |
| spellingShingle | Miguel Angel Muñoz Esther Calero Julio Duran Elena Navas Susana Alonso Nuria Argemí Marta Casademunt Patricia Furió Elena Casajuana Nuria Torralba Nuria Farre Rosa Abellana José-Maria Verdú-Rotellar On behalf of HADES Study Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study Journal of Clinical Medicine heart failure community setting predictive model mortality short term prognosis end of life |
| title | Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study |
| title_full | Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study |
| title_fullStr | Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study |
| title_full_unstemmed | Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study |
| title_short | Short-Term Mortality in Patients with Heart Failure at the End-of-Life Stages: Hades Study |
| title_sort | short term mortality in patients with heart failure at the end of life stages hades study |
| topic | heart failure community setting predictive model mortality short term prognosis end of life |
| url | https://www.mdpi.com/2077-0383/11/9/2280 |
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