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Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry

Background: Patients with heart failure encompass a heterogeneous group, but they are mostly elderly patients with a large burden of comorbid conditions. Objective: The aim of this study was to compare the clinical characteristics and the prognostic impact on hospital admissions and mortality in a p...

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Autores principales: Méndez-Bailon, Manuel, Lorenzo-Villalba, Noel, Rubio-Garcia, Jorge, Moreno-García, María Carmen, Ropero-Luis, Guillermo, Martínez-Litago, Eduardo, Quirós-López, Raúl, Carrascosa-García, Sara, González-Franco, Alvaro, Andrès, Emmanuel, Casado-Cerrada, Jesús, Montero-Pérez-Barquero, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225050/
https://www.ncbi.nlm.nih.gov/pubmed/35743586
http://dx.doi.org/10.3390/jcm11123516
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author Méndez-Bailon, Manuel
Lorenzo-Villalba, Noel
Rubio-Garcia, Jorge
Moreno-García, María Carmen
Ropero-Luis, Guillermo
Martínez-Litago, Eduardo
Quirós-López, Raúl
Carrascosa-García, Sara
González-Franco, Alvaro
Andrès, Emmanuel
Casado-Cerrada, Jesús
Montero-Pérez-Barquero, Manuel
author_facet Méndez-Bailon, Manuel
Lorenzo-Villalba, Noel
Rubio-Garcia, Jorge
Moreno-García, María Carmen
Ropero-Luis, Guillermo
Martínez-Litago, Eduardo
Quirós-López, Raúl
Carrascosa-García, Sara
González-Franco, Alvaro
Andrès, Emmanuel
Casado-Cerrada, Jesús
Montero-Pérez-Barquero, Manuel
author_sort Méndez-Bailon, Manuel
collection PubMed
description Background: Patients with heart failure encompass a heterogeneous group, but they are mostly elderly patients with a large burden of comorbid conditions. Objective: The aim of this study was to compare the clinical characteristics and the prognostic impact on hospital admissions and mortality in a population of patients with HF with different types of caregivers (family members, professionals, and the patient himself). Methods: We conducted an observational study from a prospective registry. Patients from the National Registry of Heart Failure (RICA), which belongs to the Working Group on Heart Failure and Atrial Fibrillation of the Spanish Society of Internal Medicine (SEMI), were included. Patients with heart failure were classified, according to the type of main caregiver, into four groups: the patient himself/herself, a partner, children, or a professional caregiver. A bivariable analysis was performed between the clinical, analytical, therapeutic, and prognostic characteristics of the different groups. The endpoints of the study were all-cause mortality at 1 year; mortality at 120 days; and the readmission rate for HF at 30 days, 120 days, and 1 year of follow-up. In all cases, the level of statistical significance was set at p < 0.05. Results: A total of 2147 patients were enrolled in this study; women represented 52.4%, and the mean age was 81 years. The partner was the caregiver for 703 patients, children were caregivers for 1097 patients, 199 patients had a professional caregiver, and only 148 patients were their own caregivers. Women were more frequently cared for by their children (65.8%) or a professional caregiver (61.8%); men were more frequently cared for by their spouses (68.7%) and more frequently served as their own caregivers (59.5%) (p < 0.001). No statistically significant differences were observed in relation to readmissions or mortality at one year of follow-up between the different groups. A lower probability of readmission and death was observed for patients who received care from a partner or children/relative, with log-rank scores of 11.2 with p= 0.010 and 10.8 with p = 0.013. Conclusions: Our study showed that the presence of a family caregiver for elderly patients with heart failure was associated with a lower readmission rate and a lower mortality rate at 120 days of follow-up. Our study also demonstrated that elderly patients with good cognitive and functional status can be their own caregivers, as they obtained good health outcomes in terms of readmission and mortality. More prospective studies and clinical trials are needed to evaluate the impact of different types of caregivers on the outcomes of patients with heart failure.
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spelling pubmed-92250502022-06-24 Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry Méndez-Bailon, Manuel Lorenzo-Villalba, Noel Rubio-Garcia, Jorge Moreno-García, María Carmen Ropero-Luis, Guillermo Martínez-Litago, Eduardo Quirós-López, Raúl Carrascosa-García, Sara González-Franco, Alvaro Andrès, Emmanuel Casado-Cerrada, Jesús Montero-Pérez-Barquero, Manuel J Clin Med Article Background: Patients with heart failure encompass a heterogeneous group, but they are mostly elderly patients with a large burden of comorbid conditions. Objective: The aim of this study was to compare the clinical characteristics and the prognostic impact on hospital admissions and mortality in a population of patients with HF with different types of caregivers (family members, professionals, and the patient himself). Methods: We conducted an observational study from a prospective registry. Patients from the National Registry of Heart Failure (RICA), which belongs to the Working Group on Heart Failure and Atrial Fibrillation of the Spanish Society of Internal Medicine (SEMI), were included. Patients with heart failure were classified, according to the type of main caregiver, into four groups: the patient himself/herself, a partner, children, or a professional caregiver. A bivariable analysis was performed between the clinical, analytical, therapeutic, and prognostic characteristics of the different groups. The endpoints of the study were all-cause mortality at 1 year; mortality at 120 days; and the readmission rate for HF at 30 days, 120 days, and 1 year of follow-up. In all cases, the level of statistical significance was set at p < 0.05. Results: A total of 2147 patients were enrolled in this study; women represented 52.4%, and the mean age was 81 years. The partner was the caregiver for 703 patients, children were caregivers for 1097 patients, 199 patients had a professional caregiver, and only 148 patients were their own caregivers. Women were more frequently cared for by their children (65.8%) or a professional caregiver (61.8%); men were more frequently cared for by their spouses (68.7%) and more frequently served as their own caregivers (59.5%) (p < 0.001). No statistically significant differences were observed in relation to readmissions or mortality at one year of follow-up between the different groups. A lower probability of readmission and death was observed for patients who received care from a partner or children/relative, with log-rank scores of 11.2 with p= 0.010 and 10.8 with p = 0.013. Conclusions: Our study showed that the presence of a family caregiver for elderly patients with heart failure was associated with a lower readmission rate and a lower mortality rate at 120 days of follow-up. Our study also demonstrated that elderly patients with good cognitive and functional status can be their own caregivers, as they obtained good health outcomes in terms of readmission and mortality. More prospective studies and clinical trials are needed to evaluate the impact of different types of caregivers on the outcomes of patients with heart failure. MDPI 2022-06-18 /pmc/articles/PMC9225050/ /pubmed/35743586 http://dx.doi.org/10.3390/jcm11123516 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Méndez-Bailon, Manuel
Lorenzo-Villalba, Noel
Rubio-Garcia, Jorge
Moreno-García, María Carmen
Ropero-Luis, Guillermo
Martínez-Litago, Eduardo
Quirós-López, Raúl
Carrascosa-García, Sara
González-Franco, Alvaro
Andrès, Emmanuel
Casado-Cerrada, Jesús
Montero-Pérez-Barquero, Manuel
Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title_full Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title_fullStr Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title_full_unstemmed Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title_short Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure—Analysis from the RICA Registry
title_sort clinical characteristics and prognostic relevance of different types of caregivers for elderly patients with acute heart failure—analysis from the rica registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225050/
https://www.ncbi.nlm.nih.gov/pubmed/35743586
http://dx.doi.org/10.3390/jcm11123516
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