scholarly journals Delirium is associated with high mortality in older adult patients with acute decompensated heart failure

2020 ◽  
Author(s):  
Misun Pak ◽  
Masahiko Hara ◽  
Shoko Miura ◽  
Motohide Furuya ◽  
Masatake Tamaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Older Adult ◽  
High Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Adult Patients ◽  
Prognostic Impact ◽  
Clinical Frailty Scale ◽  
All Cause Mortality

Abstract Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia.Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the older adult patients with ADHF. Hyperactive delirium was the most common subtype.

scholarly journals Delirium is associated with high mortality in older adult patients with acute decompensated heart failure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Misun Pak ◽  
Masahiko Hara ◽  
Shoko Miura ◽  
Motohide Furuya ◽  
Masatake Tamaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Older Adult ◽  
High Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Adult Patients ◽  
Prognostic Impact ◽  
Clinical Frailty Scale ◽  
All Cause Mortality

Abstract Background Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF. Methods This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p = 0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p = 0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia. Conclusions Delirium was associated with a higher 90-day all-cause mortality in the older adult patients with ADHF. Hyperactive delirium was the most common subtype.

scholarly journals Delirium is Associated with High Mortality in Elderly patients with Acute Decompensated Heart Failure

2020 ◽  
Author(s):  
Misun Pak ◽  
Masahiko Hara ◽  
Shoko Miura ◽  
Motohide Furuya ◽  
Masatake Tamaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Elderly Patients ◽  
High Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
The Elderly ◽  
Prognostic Impact ◽  
Clinical Frailty Scale ◽  
All Cause Mortality

Abstract Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia.Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.

scholarly journals Delirium is associated with high mortality in elderly patients with acute decompensated heart failure

2020 ◽  
Author(s):  
Misun Pak ◽  
Masahiko Hara ◽  
Shoko Miura ◽  
Motohide Furuya ◽  
Masatake Tamaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Elderly Patients ◽  
High Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
The Elderly ◽  
Prognostic Impact ◽  
Clinical Frailty Scale ◽  
All Cause Mortality

Abstract Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF. Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia. Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.

scholarly journals Delirium is associated with high mortality in elderly patients with acute decompensated heart failure

2020 ◽  
Author(s):  
Misun Pak ◽  
Masahiko Hara ◽  
Shoko Miura ◽  
Motohide Furuya ◽  
Masatake Tamaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Elderly Patients ◽  
High Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
The Elderly ◽  
Prognostic Impact ◽  
Clinical Frailty Scale ◽  
All Cause Mortality

Abstract Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF. Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia. Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.

scholarly journals Pneumonia and inflammation in acute decompensated heart failure: a registry-based analysis of 1939 patients

2017 ◽  
Vol 7 (4) ◽  
pp. 362-370 ◽  
Author(s):  
Alexander Jobs ◽  
Ronja Simon ◽  
Suzanne de Waha ◽  
Kyrill Rogacev ◽  
Alexander Katalinic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Prognostic Impact ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
All Cause Mortality

Background: The prognostic impact of pneumonia and signs of systemic inflammation in patients with acute decompensated heart failure (ADHF) has not been fully elucidated yet. The aim of the present study was thus to investigate the association of pneumonia and the inflammation surrogate C-reactive protein with all-cause mortality in patients admitted for ADHF. Methods: We analysed data of 1939 patients admitted for ADHF. Patients were dichotomised according to the presence or absence of pneumonia. The primary endpoint of all-cause mortality was determined by death registry linkage. Results: In total, 412 (21.2%) patients had concomitant pneumonia. Median C-reactive protein levels were higher in patients with compared to patients without pneumonia (24.9 versus 9.8 mg/l, respectively; P<0.001). All-cause mortality was significantly higher in patients with pneumonia ( P<0.001). In adjusted Cox regression models, pneumonia as well as C-reactive protein were independently associated with in-hospital mortality. Only C-reactive protein remained as independent predictor for long-term mortality. Conclusion: Pneumonia is relatively common in ADHF and a predictor for in-hospital mortality. However, inflammation in general seems to be more important than pneumonia itself for long-term prognosis. Compared to community-acquired pneumonia studies, C-reactive protein levels were rather low and therefore pneumonia might be over-diagnosed in ADHF patients.

Abstract 14471: Prognostic Impact of Sarcopenia in Men versus Women With Acute Decompensated Heart Failure and Preserved Left Ventricular Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takanari Kimura ◽  
Shungo Hikoso ◽  
Nakatani Daisaku ◽  
Shunsuke Tamaki ◽  
Masamichi Yano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Fat Free Mass ◽  
Left Ventricular Ejection ◽  
Prognostic Impact ◽  
Ventricular Ejection Fraction ◽  
Multicenter Observational Study

Background: Sarcopenia is associated with poor prognosis in chronic heart failure. Fat-free mass index (FFMI) is an indicator of resting energy expenditure and has been used for the clinical diagnosis of sarcopenia. However, the prognostic impact of sarcopenia diagnosed by FFMI remains to be elucidated in patients admitted with acute decompensated heart failure (ADHF) and preserved LVEF (HFpEF), relating to gender. Methods: Patients' data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF) study, which is a prospective multicenter observational registry for ADHF patients with LVEF ≥50% in Osaka. We studied 621 patients who survived to discharge (men, n=281 and women, n=340). Fat-free mass (FFM) was estimated by the formula [FFM (kg) = 7.38 + 0.02908 х urinary creatinine (mg/day)] and normalized by the square of the patient’s height in meters to calculate FFMI at discharge. Sarcopenia was defined as FFMI <17 kg/m2 in men and <15 kg/m2 in women. The endpoint was all-cause death. Results: During a follow-up period of 1.5±0.8 yrs, 102 patients died (men, n=46 and women, n=56). At multivariate Cox analysis, FFMI was significantly associated with the mortality independently of age, estimated glomerular filtration rate, NT-proBNP and LVEF in both men (p=0.0155) and women (p=0.0223). Patients with sarcopenia had a significantly higher risk of all-cause death than those without sarcopenia in both genders (Figure). Conclusions: In this multicenter study, sarcopenia diagnosed by FFMI was shown to be associated with poor clinical outcome in HFpEF patients admitted with ADHF in both genders.

Risk Factors for AKI Development in Acute Decompensated Heart Failure

2020 ◽  
pp. 69-83
Author(s):  
Nobuhiko Joki ◽  
Yasushi Ohashi ◽  
Yuri Tanaka ◽  
Toshihide Hayashi ◽  
Ken Sakai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

Risk Factors for Poor Outcomes in Children Hospitalized With Acute Decompensated Heart Failure

2018 ◽  
Vol 37 (4) ◽  
pp. S391
Author(s):  
B. Hong ◽  
J. Friedland-Little ◽  
E. Albers ◽  
N. Jorgensen ◽  
R. Mazor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Poor Outcomes

P15 Serum chloride as marker for prognosis for patient with acute decompensated heart failure: a systematic review and meta-analysis on prognosis

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
L K Evangelista ◽  
J D Ramos ◽  
D L Villanueva ◽  
M D Tiongson ◽  
F E Punzalan
Keyword(s):  
Heart Failure ◽  
Cohort Studies ◽  
Quality Assessment ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Cochrane Central Register ◽  
Serum Chloride ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Acute Decompensation

Abstract Background  Several studies have suggested that hypochloremia is associated with adverse outcomes among patients with heart failure. The association appears to be more marked in those with acute decompensation. Research Question: What is the association of hypochloremia with mortality and worsening heart failure among patients in acute decompensation? Objective Determine the association of admission hypochloremia to all-cause mortality, heart failure death and worsening heart failure among patients with acute decompensated heart failure. Criteria for Inclusion of Studies: Studies were included if they satisfied the following criteria 1) observational cohort studies; 2) included patients admitted for acute decompensated heart failure; and 3) reported data on mortality and worsening heart failure in association with admission hypochloremia. Methods A systematic search using MEDLINE, Clinical Key, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials databases was done, from June 2018 to January 31, 2019. The characteristics of included studies were collated. Data abstraction and quality assessment, using the Newcastle-Ottawa Quality Assessment Scale, were done independently by two reviewers, and disagreements were settled by a third reviewer. Review Manager (RevMan) 5.3 was utilized to perform Mantel-Haenzel analysis of random effects and compute for relative risk. Results We included three high quality cohort studies involving 3,444 patients admitted for acute decompensated heart failure and having low serum chloride levels on admission. Our study shows that admission hypochloremia is associated with increased risk for all-cause mortality [RR 1.63, (95% CI 1.60 to 2.28, p &lt; 0.00001]. Risks for heart failure death as mentioned in one study and worsening heart failure also in one study are likewise increased with hypochloremia on admission.  Conclusion Admission hypochloremia is associated with higher all-cause mortality among patients admitted for acute decompensated heart failure. The risk for heart failure death and worsening heart failure are also increased. Admission hypochloremia may be a useful prognosticator for heart failure patients.

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