Targeted Geriatric Assessment to Predict Outcomes in Older Adults With Heart Failure

Résumé fourni par la source

BACKGROUND: Health care for older adults with heart failure (HF) has primarily focused on cardiovascular assessment, with limited attention to geriatric conditions that might affect meaningful clinical outcomes. OBJECTIVES: The purpose of this study was to evaluate whether the 10-minute Targeted Geriatric Assessment (10-TaGA) enhances the prediction of clinical outcomes in older adults with HF. METHODS: Prospective cohort study of HF patients consecutively admitted to a geriatric day hospital in Brazil. Cox proportional hazard models assessed 1-year all-cause mortality, hospitalization, HF hospitalization, and days of health lost among 10-TaGA score tertiles (low-, intermediate-, and high-risk groups), adjusted for clinical variables and the Cardiac and Comorbid Conditions Heart Failure risk score. RESULTS: Among the 326 patients included (mean age 80.9 ± 7.7 years; 37.7% female; 59.8% identified as White), 76 died within 1 year. We observed a graded association between 10-TaGA risk categories and the primary outcome of all-cause mortality or hospitalization (low-risk, reference; intermediate-risk, adjusted HR: 1.41 [95% CI: 0.96-2.05]; high-risk, adjusted HR: 1.97 [95% CI: 1.30-2.99]). Similar trend was found for days of health lost (mean difference of +22 days [95% CI: -2 to +45] and +49 days [95% CI: +9 to +88] for the intermediate- and high-risk groups). Adding the 10-TaGA to clinical variables and the Cardiac and Comorbid Conditions Heart Failure improved discrimination for all-cause mortality/hospitalization (time-specific difference in area under the curve at 1 year: 0.04 [95% CI: 0.01-0.08]; P = 0.025). CONCLUSIONS: In older adults with HF referred to the geriatric day hospital, the 10-TaGA provided clinically relevant information beyond standard cardiac assessments and may support effective patient-centered care.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.