Key result
Specific clusters of comorbidities and the Charlson comorbidity index were associated with in-hospital death among elderly patients with acute heart failure (overall mortality 12%).
Why the study?
Elderly patients with acute heart failure often present with diverse comorbidity patterns, but it is unclear how chronic comorbidities cluster and which patterns most strongly predict in-hospital mortality.
Cohort (n=459)
No
Specific clusters of comorbidities are more strongly associated with in-hospital death from acute heart failure in elderly patients than generic scales like the Charlson comorbidity index.
May enhance risk stratification in elderly acute HF; leaves open targeted interventions for high-risk clusters.
Background and Objectives: Elderly patients affected by acute heart failure (AHF) often show different patterns of comorbidities. In this paper, we aimed to evaluate how chronic comorbidities cluster and which pattern of comorbidities is more strongly related to in-hospital death in AHF. Materials and Methods: All patients admitted for AHF to an Internal Medicine Department (01/2015−01/2019) were retrospectively evaluated; the main outcome of this study was in-hospital death during an admission for AHF; age, sex, the Charlson comorbidity index (CCI), and 17 different chronic pathologies were investigated; the association between the comorbidities was studied with Pearson’s bivariate test, considering a level of p ≤ 0.10 significant, and considering p < 0.05 strongly significant. Thus, we identified the clusters of comorbidities associated with the main outcome and tested the CCI and each cluster against in-hospital death with logistic regression analysis, assessing the accuracy of the prediction with ROC curve analysis. Results: A total of 459 consecutive patients (age: 83.9 ± 8.02 years; males: 56.6%). A total of 55 (12%) subjects reached the main outcome; the CCI and 16 clusters of comorbidities emerged as being associated with in-hospital death from AHF. Of these, CCI and six clusters showed an accurate prediction of in-hospital death. Conclusions: Both the CCI and specific clusters of comorbidities are associated with in-hospital death from AHF among elderly patients. Specific phenotypes show a greater association with a worse short-term prognosis than a more generic scale, such as the CCI.
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Falsetti et al. (2022) conducted a cohort in acute heart failure (n=459). Clusters of comorbidities was evaluated on in-hospital death during an admission for AHF. Specific clusters of comorbidities and the Charlson comorbidity index were associated with in-hospital death among elderly patients with acute heart failure (overall mortality 12%).
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