[Correlation between evolution of the cognitive function and mortality after hospital discharge in elderly patients with advanced heart failure].

Abstract:

OBJECTIVE:To assess the relation between the evolution of cognitive performance and the prognosis of elderly patients after compensation of advanced heart failure. METHODS:Thirty-one patients older than 64 (68 +/- 7) years and admitted with New York Heart Association class IV heart failure and ejection fraction = 0.45 (0.38 +/- 0.06) were consecutively selected. They underwent cognitive tests (digit span, digit symbol, letter cancellation, trail making A and B) and the 6-minute walking test 4 days before (T1) and 6 weeks after (T2) hospital discharge, and their performances were compared using the t test. The prognostic value of the scores of the cognitive tests was analyzed with logistic regression, and the value of greatest accuracy of the tests was associated with the prognosis determined by the ROC curve. RESULTS:After 24.7 months, 17 (55%) patients had died. The performances in the 6-minute walking test and most cognitive tests improved between T1 and T2. The digit span score of the survivors ranged from 3.9 to 5.2 (P=0.003) and remained unaltered among those who died (4.1 to 3.9; P=0.496). An improvement < 0.75 points in the score was associated with mortality (relative risk of 8.1; P=0.011). CONCLUSION:In the elderly, after compensation of advanced heart failure, the lack of evolutionary improvement in cognitive performance was associated with a worse prognosis.

journal_name

Arq Bras Cardiol

authors

Ochiai ME,Franco LL,Gebara OC,Nussbacher A,Serro-Azul JB,Pierri H,Rays J,Barretto AC,Wajngarten M

doi

10.1590/s0066-782x2004000300005

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

251-4

issue

3

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2004000300005

journal_volume

82

pub_type

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