Abstract 16523: Prevalence of Major Geriatric Syndromes in Older Patients Hospitalized for Acute Cardiac Conditions in a Cardiology Unit and Influence in 1-Year Outcomes
Background: Geriatric syndromes are prevalent multi-factorial conditions seen in elderly patients that increase their vulnerability, and influence their treatment and prognosis. The aim of the study was to address the prevalence of major geriatric syndromes (MGS) on admission in elderly patients hospitalized in a cardiology unit and their influence in post-discharge evolution.
Methods: Observational study of consecutive patients aged >=75 years admitted through the ER to an acute cardiology unit at a large university hospital. MGS was defined as the presence of at least one of the following: frailty, cognitive impairment, severe dependence or depression as assessed (prospectively) after admission by a geriatrician. Patients were followed-up for 12 months, and vital and functional status compared according to the presence of GMS with adjustment for age and comorbidity by logistic regression analysis.
Results: During 3 months, there were 211 urgent admissions of older patients (age 82±5 years, 51% women). The prevalence of at least one MGS was 60.2 %, frailty (40.8%), cognitive impairment (31.8%), severe dependency (14.7%), and depression (4.3%). Patients with MGS were older (82±5 vs 81±4 years, p=0.02) but did not have greater disease severity or comorbidity. Those with MGS did not have higher in hospital mortality (3.9 vs 2.4%, p=0.5) but showed worse outcomes at 12 months (Table) After adjustment for age and comorbidity, MGS on admission was independently associated with 12-month mortality (OR, 1.9; 95%CI, 0.9-4.1), readmission (OR, 2.03; 95%CI, 1.04-4.0), functional decline (OR, 3.1; 95%CI, 1.5-6.5) and need for new help (OR; 3.3; 95%CI, 1.6- 7.2).
Conclusions: A majority of elderly patients hospitalized for acute cardiac conditions show at least one MGS on admission. MGS usually not considered in cardiac risk evaluation are associated with poorer long-term outcomes. Further research on the management implications of MGS in cardiac patients is warranted.
- © 2010 by American Heart Association, Inc.