Background: Comorbidities negatively affect acute heart failure(AHF). We aimed to evaluate if different groups of comorbiditiesdifferently affect AHF prognosis in elderly patients.Materials and Methods:We enrolled AHF patients investigatingage, sex, in-hospital mortality and presence of 16 common in-ternistic comorbidities. Association of chronic pathologies was ex-plored with Pearson’s bivariate test, selecting clusters of ≥2significantly associated comorbidities. We obtained ROC curves predicting in-hospital mortality for AHF from binary logistic regressions adopting each cluster as predictor.Results:Mean age was 82.56(±8,92), females representing53.7% of the sample. In-hospital mortality was 13%. We obtained11 different clusters, 6 of which predicting significantly in-hospital mortality. The first (anaemia, dementia, diabetes, AF) had AUC:0.678; 95% CI:0.585-0.810; p=0.032. The second (hypertension,CKD, CVD) had AUC: 0.673; 95% CI:0.525-0.821; p=0.037. Thethird (dyslipidaemia, AF, PAD, CVD, haematologic disorders) hadAUC: 0.716; 95% CI: 0.564-0.868; p=0.009. The fourth (AF,anaemia, dyslipidaemia, diabetes, CVD, IPB) had AUC: 0.764;95% CI: 0.658-0.870; p=0.002. The fifth (CVD, OSAS, dyslipidaemia, AF, PAD, rheumatologic diseases) had AUC: 0.687; 95% CI: 0.557-0.818; p=0.024. The last (OSAS, AF, IPB) had AUC:0.695; 95% CI: 0.565-0.825; p=0.019.Discussion:In this small sample, some clusters of comorbiditieswere not associated to an increased risk of in-hospital mortalityin AHF. Patterns strongly associated to in-hospital death deservethe best attention and the most extensive therapy.
Clusters of comorbidities have different impact in short-term prognosis of acute heart failure
L. FalsettiWriting – Original Draft Preparation
;
2017
Abstract
Background: Comorbidities negatively affect acute heart failure(AHF). We aimed to evaluate if different groups of comorbiditiesdifferently affect AHF prognosis in elderly patients.Materials and Methods:We enrolled AHF patients investigatingage, sex, in-hospital mortality and presence of 16 common in-ternistic comorbidities. Association of chronic pathologies was ex-plored with Pearson’s bivariate test, selecting clusters of ≥2significantly associated comorbidities. We obtained ROC curves predicting in-hospital mortality for AHF from binary logistic regressions adopting each cluster as predictor.Results:Mean age was 82.56(±8,92), females representing53.7% of the sample. In-hospital mortality was 13%. We obtained11 different clusters, 6 of which predicting significantly in-hospital mortality. The first (anaemia, dementia, diabetes, AF) had AUC:0.678; 95% CI:0.585-0.810; p=0.032. The second (hypertension,CKD, CVD) had AUC: 0.673; 95% CI:0.525-0.821; p=0.037. Thethird (dyslipidaemia, AF, PAD, CVD, haematologic disorders) hadAUC: 0.716; 95% CI: 0.564-0.868; p=0.009. The fourth (AF,anaemia, dyslipidaemia, diabetes, CVD, IPB) had AUC: 0.764;95% CI: 0.658-0.870; p=0.002. The fifth (CVD, OSAS, dyslipidaemia, AF, PAD, rheumatologic diseases) had AUC: 0.687; 95% CI: 0.557-0.818; p=0.024. The last (OSAS, AF, IPB) had AUC:0.695; 95% CI: 0.565-0.825; p=0.019.Discussion:In this small sample, some clusters of comorbiditieswere not associated to an increased risk of in-hospital mortalityin AHF. Patterns strongly associated to in-hospital death deservethe best attention and the most extensive therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.