• 作者：M. Montero Pé ; rez-Barquero^a ; ^{mmontero@cica.es} ; P. Conthe Gutié ; rrez^b ; P. Romá ; n Sá ; nchez^c ; J. Garcí ; a Alegrí ; a^d ; J. Forteza-Rey^e ; Grupo de Trabajo de Insuficiencia Cardiaca de la Sociedad Españ ; ola de Medicina Interna (estudio SEMI-IC)^&diams ;
• 关键词：Insuficiencia cardiaca ; Comorbilidad ; Medicina interna ; Í ; ndice de Charlson
• 刊名：Revista Cl铆nica Espa帽ola
• 出版年：2010
• 期刊代码：pca307_00142565
• 类别：med
• 出版时间：April 2010
• 卷：210
• 期：4
• 页码：149-158
• 文件大小：205 K

Background and objetives

Heart Failure (HF) patients present frecuently comorbidities. Little is known about the impact of these comorbidities in morbimortality. We analized the comorbidities of HF patients admitted in Spanish internal medicine units and its relation with different socio-demografics and clinical variables.

Patients and methods

We studied prospectivaly 2127 patients (admitted from 01.10.2000 鈥?#xA0;28.02.2001) with HF in 51 Hospitals of different categories (from local hospitals to universitary hospitals) in which an internist was available to collaborate in the study. Comorbidities were estimated by the Charlson index.

Results

Mean age was 77 years (women 57%). 45%of patients have had a previous admission in the last year. 41%had a functional stage NYHA iii/iv.

Eyection fraction was preserved in 53%of patients. Comorbidities were identified in 60%of patients (diabetes mellitus, 39%; chronic lung disease 31%). The average Charlson index was 5.4 points (range 2 鈥?#xA0;11 points). Global inhospital mortality was 6.1%. During the admission more patients died in the Group with higher comorbidities (Charlson, >3 points; 8.4%) than in the Group with low Charlson index (1 鈥?#xA0;2, 5.2%; p<0.01). Treatments prescribed were similar in both groups. In a multivariant analisis comorbidities was associated independently with masculin gender, age superior to 75 years, functional status NYHA iii/iv and disfunctional physical capacity.

Conclusions

Comorbidities determined by Charlson index were associated with more frequent admission, longer stay in hospital, higher discapacity and higher mortality. These results enhance the importance of comorbidities in prognosis of heart failure patients admitted in internal medicine units in Spain.