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Vol. 217. Issue 2.
Pages 87-94 (March 2017)
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Vol. 217. Issue 2.
Pages 87-94 (March 2017)
Original article
Prevalence of comorbidities and the prognostic value of the PROFUND index in a hospital cardiology unit
Prevalencia de pluripatología y valor pronóstico del índice PROFUND en una unidad de hospitalización de Cardiología
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M.A. López-Garridoa,
Corresponding author
milopga@gmail.com

Corresponding author.
, I. Antequera Martín-Portuguésb, V.M. Becerra-Muñoza, H.N. Orellana-Figueroaa, F.J. Sánchez-Lorab, L. Morcillo-Hidalgoa, M.F. Jiménez-Navarroa, J.J. Gómez-Doblasa, E. de Teresa-Galvána, J.M. García-Pinillaa
a Unidad de Gestión Clínica del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, Spain
b Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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Figures (2)
Tables (3)
Table 1. Baseline characteristics of the sample and analysis of the subgroup of polypathological patient.
Table 2. Differential characteristics between the patients who died and those who survived and between those who had a major adverse event at 1 year of follow-up and those who did not.
Table 3. Variables associated with overall mortality and major adverse events at 1 year of follow-up.
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Abstract
Introduction

The aim of this study was to understand the prevalence of comorbidities and the usefulness of the PROFUND index for the prognostic stratification of patients with comorbidities in a hospital cardiology unit.

Patients and methods

We consecutively analysed all patients hospitalized in 2012 in the department of cardiology. We recorded the comorbidities, length of stay, hospital mortality, Charlson indices and PROFUND indices. In the patients with comorbidities, we also recorded the readmissions and mortality during a 1-year follow-up.

Results

The study included 1033 patients (mean age, 67±13.1 years; 35% women), 381 (36.9%) of whom had comorbidities, with a mean Charlson index of 6.4±1.7 and a mean PROFUND index of 2.5±2.5. Compared with the other patients, the patients with comorbidities were older (72 vs. 64 years, p<.001), had a higher mortality rate (2.9% vs. 1.1%, p=.046) and longer hospital stays (8±5.5 vs. 6±5.7 days, p<.001) and were more often admitted for heart failure (42.3% vs. 15.8%, p<.001). The PROFUND index was independently associated with overall mortality (hazard ratio [HR], 1.13; 95% CI: 1.01–1.27; p=.034) and with the presence of major adverse events during the 12-month follow-up (HR, 1.09; 95% CI: 1.01–1.18; p=.026).

Conclusions

A high percentage of patients hospitalized in the department of cardiology had comorbidities. These patients had a higher prevalence of cardiovascular risk factors, longer stays and greater hospital mortality. The PROFUND index independently predicted mortality and adverse events during the follow-up.

Keywords:
Comorbidities
Multiple diseases
Heart failure
Prognosis
PROFUND index
Resumen
Introducción

El objetivo del estudio fue conocer la prevalencia de pluripatología y la utilidad del índice PROFUND para la estratificación pronóstica de los pacientes pluripatológicos en una unidad de hospitalización de Cardiología.

Pacientes y métodos

Se analizaron de forma consecutiva todos los pacientes ingresados en 2012 en el servicio de Cardiología. Se registraron las comorbilidades, estancia y mortalidad intrahospitalarias, y los índices de Charlson y PROFUND. En los pacientes pluripatológicos, se registraron además los reingresos y la mortalidad durante un año de seguimiento.

Resultados

Se incluyeron 1.033 pacientes (67±13,1 años, 35% mujeres); 381 (36,9%) fueron pluripatológicos, con un índice de Charlson de 6,4±1,7 y PROFUND de 2,5±2,5. Comparados con el resto, los pluripatológicos fueron mayores (72 vs. 64 años, p<0,001), tuvieron más mortalidad (2,9% vs. 1,1%, p=0,046) y estancia intrahospitalarias (8±5,5 vs. 6±5,7 días, p<0,001) e ingresaron más por insuficiencia cardiaca (42,3% vs. 15,8%, p<0,001). El índice PROFUND se asoció de manera independiente con la mortalidad global (hazard ratio[HR]=1,13, intervalo de confianza [IC] del 95%: 1,01-1,27, p=0,034) y con la existencia de eventos adversos mayores en el seguimiento a 12 meses (HR=1,09, IC del 95%: 1,01-1,18, p=0,026).

Conclusiones

Un alto porcentaje de los pacientes ingresados en Cardiología fueron pluripatológicos. Estos presentaron mayor prevalencia de factores de riesgo cardiovascular, mayor estancia y mortalidad intrahospitalarias. El índice PROFUND predijo de forma independiente la mortalidad y los acontecimientos adversos durante el seguimiento.

Palabras clave:
Comorbilidades
Pluripatología
Insuficiencia cardiaca
Pronóstico
Índice PROFUND

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