Clinical studyThe effects of cognitive impairment on mortality among hospitalized patients with heart failure☆
Section snippets
Study sample
We used the database of the Gruppo Italiano di Farmacoepidemiologia nell’Anziano (GIFA), a collaborative pharmacoepidemiology hospital study (16). Briefly, all patients admitted to 81 clinical centers (either geriatric or internal medicine hospital wards) throughout Italy from May 1 to June 30 and from September 1 to October 31 in 1988, 1991, 1993, 1995, and 1997 were enrolled on admission and followed until discharge, without exclusion criteria. The 16,913 participants included patients of all
Results
Among the 16,913 participants in the GIFA database who were suitable for analysis during the years of interest, cognitive dysfunction was detected in 35% (647/1860) of participants with any diagnosis of heart failure, and in 28% (4229/15,053) of the remaining subjects (P <0.0001). Among those with heart failure, the mean (± SD) length of hospital stay was similar for patients with cognitive impairment (15 ± 10 days) as compared with those with normal cognitive functioning (15 ± 9 days).
Among
Discussion
We found that cognitive impairment was associated with decreased survival among older patients hospitalized for heart failure. This suggests that diminished cognition, as diagnosed by simple neuropsychological testing, might be a new prognostic marker for the routine assessment of these patients. The association between cognitive impairment and in-hospital mortality was not explained by delayed discharge from hospital, or by reduced availability of caregivers for home care. In addition,
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The Gruppo Italiano di Farmacoepidemiologia nell’Anziano (GIFA) study was supported by a grant (n. 94000402) from the National Research Council, Rome, Italy.