Objective: To analyze the clinical characteristics of patients with decompensated heart failure who are brought to a hospital emergency department and to describe the long-term clinical course in these patients. Methods: Prospective observational study of 60 emergency patients with decompensated heart failure. We used the Confusional Assessment Method to assess the presence of delirium and subsyndromal delirium. The patients were followed by means of telephone interviews for 1 year. Results: The mean (SD) age was 80.5 (11); 61.7% were women. Delirium was detected in 11.7% and subsyndromal delirium in 3.3%. Patients with delirium were older (P=.004), showed greater dependency with respect to both instrumental activities of daily living (ADLs) (P=.001) and basic ADLs (Barthel index) (P=.001), and had higher rates of dementia (P=.007) and peripheral vascular disease (P=.029). No significant differences were detected in the causes or characteristics of heart failure between the patients with and without delirium. Two patients with delirium died in hospital (P=.23). Only 2 patients with delirium survived the year of follow-up (P=.4); both showed cognitive dysfunction and high levels of functional dependency. Conclusions: Delirium in patients with decompensated heart failure seems to be more associated with older age, a baseline situation of functional dependency, and cognitive decline than with the seriousness or stage of heart failure.
|Publication status||Published - 3 Sep 2012|
- Decompensated heart failure
- Emergency health services