La pluripatología en una unidad de insuficiencia cardíaca: la perspectiva de un internista

  1. Marta Rafael Marques 1
  2. Helena Gonçalves 2
  3. Joana Calvao 2
  4. Josebe Gairigolzarri 3
  5. Manuel Mendez 3
  6. Ramon Bover 3
  7. Isidre Vilacosta 3
  8. Carlos Macaya 3
  1. 1 Centro Hospitalar Povoa de Varzim/ Vila do Conde. Povoa de Varzim, Portugal
  2. 2 Centro Hospitalar de Trás-os-Montes e Alto Douro. Vila Real, Portugal
  3. 3 Hospital Clínico San Carlos. Madrid, España
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Journal:
Galicia Clínica

ISSN: 0304-4866,  1989-3922

Year of publication: 2021

Volume: 82

Issue: 2

Pages: 81-86

Type: Article

DOI: 10.22546/61/2249 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Galicia Clínica

Abstract

Objectives: to determine the frequency of pluripathology in a Heart Failure Unit, defining the characteristics of pluripathological patients and their vital prognosis according to two models: PROFUND score and Seattle Heart Failure Model. Methods: consecutive patients from a Heart Failure Unit of a third level hospital were analized during two months. Comorbidities, pluripathology categories and Charlson, Barthel, Seattle Heart Failure Model and PROFUND scores were registered. Results: 246 patients were included, of which 118 (48%) were pluripathological, with Charlson score 7.9 ± 3.8 and PROFUND 3.5 ± 7.1. The most prevalent category of pluripathology was A, followed by B and C. The pluripathological patients were older (77 vs. 73 years, p = 0.001), more fragile, with greater functional limitation (Barthel: 84.7 vs. 96, 1, p <0.001), higher prevalence of cardiovascular risk factors and chronic diseases and admitted more (14.4 vs. 4.7, p = 0.015). The most frequent etiology was ischemic heart disease. The pluripathological patients had more advanced functional class NHYA III-IV (4.2 vs. 0.8, p <0.001), higher NT-proBNP (2985 pg/ml vs. 1780 pg/ml, p = 0.013) and required higher dose of diuretics (60 vs 40, p <0.001). A concordance in the mortality estimate between the PROFUND and the Seattle Heart Failure Model was verified. Conclusion: Our study demonstrates the high frequency of pluripathological patients in a heart failure unit, population with great fragility, due to functional dependence and the association of comorbidities, that requires a multidisciplinary approach

Data source: Dialnet