Comprehensive Geriatric Assessment and 2-Year Mortality in Elderly Patients Hospitalized for Heart Failure
Background—In older adults hospitalized for heart failure, a poor score on a comprehensive geriatric assessment (CGA) is associated with worse prognosis during hospitalization and at 1 month after discharge. However, the association between the CGA score and long-term mortality is uncertain.
Methods and Results—This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0–10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11–1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25–2.54) with ≥3 versus 0 limitations in activities of daily living, 1.36 (1.0–1.86) with moderate or severe versus no or mild limitation in mobility, 1.98 (1.29–3.03) with a ≥5 versus ≤1 score on the Charlson index, 2.48 (1.84–3.34) with previous cognitive decline, and 1.77 (0.99–3.18) in those using ≥8 versus ≤3 medications.
Conclusions—The score on a simple CGA is associated with long-term mortality in older patients hospitalized for heart failure.
- Received August 20, 2013.
- Accepted January 27, 2014.
- © 2014 American Heart Association, Inc.