DASC-21 score and the risk of in-hospital death in elderly patients with heart failure.
Geriatr Gerontol Int
; 24(6): 546-553, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38703082
ABSTRACT
AIM:
We investigated whether the Dementia Assessment Sheet for Community-based Integrated Care System-21 Items (DASC-21), a questionnaire that assesses cognitive function, including activities of daily living (ADL), was predictive of in-hospital death and prolonged hospital stay in elderly patients hospitalized for heart failure.METHODS:
We retrospectively assessed the DASC-21 score at the time of admission, in-hospital death, length of hospital stay, and change in the Barthel index in 399 patients hospitalized for heart failure between 2016 and 2019.RESULTS:
The mean patient age was 85.8 ± 7.7 years (61.3% women). The median DASC-21 score was 38 (64.7% higher than 31). On multivariate logistic regression analysis, a higher DASC-21 score was associated with an increased risk of in-hospital death (odds ratio [OR] = 1.045 per 1 point increase, 95% confidence interval [CI] 1.010-1.081, P = 0.012), even after adjusting for confounding factors, including atrial fibrillation, ejection fraction, and B-type natriuretic peptide. Difficulties (3 or 4) with the self-management of medication in instrumental ADL inside the home (OR = 3.28, 95% CI 1.05-10.28, P = 0.042), toileting (OR = 3.66, 95% CI 1.19-11.29, P = 0.024), grooming (OR = 6.47, 95% CI 2.00-20.96, P = 0.002), eating (OR = 7.96, 95% CI 2.49-25.45, P < 0.001), and mobility in physical ADL (OR = 5.99, 95% CI 1.85-19.35, P = 0.003) were identified as risk factors for in-hospital death. Patients in the highest tertile of the DASC-21 score had a significantly longer hospital stay (P = 0.006) and a greater reduction in the Barthel index (P < 0.001).CONCLUSIONS:
In elderly patients hospitalized for heart failure, higher DASC-21 scores were associated with an increased risk of in-hospital death, prolonged hospital stay, and impaired ADL. Geriatr Gerontol Int 2024; 24 546-553.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
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Avaliação Geriátrica
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Mortalidade Hospitalar
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Insuficiência Cardíaca
Limite:
Aged
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Aged80
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Female
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Humans
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Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Geriatr Gerontol Int
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão