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Impact of Functional Decline on Outcome in Elderly Patients With Acute Coronary Syndromes.
MedLine Citation:
PMID:  23283095     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background Management of acute coronary syndromes in elderly patients is poorly defined. Objective To assess the impact of functional decline on all-cause mortality in elderly patients with acute coronary syndromes. Method Clinical data, including the Global Registry of Acute Coronary Events score and assessment of functional status obtained by using the Katz scale, were prospectively collected on 272 patients 70 years or older hospitalized for acute coronary syndromes. All-cause mortality was assessed at 6 months, and longer term outcome data were obtained. Results Mean age of the patients was 78 years (SD, 6), and 58% were men. A total of 28% had functional decline. Six months after the index hospitalization, 38 patients had died. Another 29 patients died during a median follow-up of 611 days after the initial 6 months. Functional decline was associated with both 6-month (hazards ratio, 3.63; 95% CI, 1.91-6.88; P < .001) and long-term (hazards ratio, 2.69; 95% CI, 1.28-5.64; P = .009) outcomes. Functional decline remained associated with both 6-month and long-term outcomes in multivariate analysis and was systematically selected in the most predictive multivariate models for 6-month and long-term mortality. The multivariate model including the Global Registry of Acute Coronary Events score and functional decline was predictive of 6-month mortality, but the combination of functional decline and biological data was more predictive of long-term mortality than was a model combining functional decline and the Global Registry score. Conclusions Functional decline in elderly patients with acute coronary syndromes is predictive of poor outcomes.
Authors:
Vincent Decourcelle; Sylvestre Maréchaux; Claire Pinçon; Stéphanie Barrailler; Thierry H Le Jemtel; Pierre Vladimir Ennezat
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  22     ISSN:  1937-710X     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  e1-e11     Citation Subset:  -    
Affiliation:
Vincent Decourcelle and Stéphanie Barrailler were cardiology fellows and Pierre Vladimir Ennezat is a senior cardiologist in the cardiology intensive care unit, Centre Hospitalier Régional et Universitaire de Lille and Member of l'Institut Fédératif de Recherche 114, EA 2693, Université Lille Nord de France, Lille, France. Sylvestre Maréchaux is an associate professor in the Department of Cardiology, Groupe Hospitalier de l'Institut Catholique de Lille/Faculté Libre de Médecine, Lille, France. Claire Pinçon is an associate professor in the Department of Biostatistics, Faculté de Pharmacie de Lille, Université Lille Nord de France. Thierry H. Le Jemtel is a professor of medicine, School of Medicine, Tulane University, New Orleans, Louisiana.
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