SPC365

Prognosis in oldest adults after hospitalization in a cardiac intense care unit – the age paradox

Session: Posters (Sessão 2 - Écran 2) - Cardiologia em Populações Especiais 2
Speaker: Isabel Cruz

Congress: CPC 2023
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.14 Cardiovascular Disease in Special Populations - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Isabel Cruz; Rafaela Lopes; Bruno Bragança; Inês Campos; Inês Oliveira; Maria Luisa Olim; Joel Monteiro; Marta Ponte; Adelaide Dias; Daniel Caeiro; Rui Pontes Dos Santos; Aurora Andrade; Ricardo Fontes de Carvalho

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>1. Introduction</strong><br />
With increasing age more c<span style="background-color:white"><span style="color:black">ritically ill oldest-old adults are being admitted in </span></span>cardiac intense care units (CICU). This is a particularly frail subgroup of patients (pts), often underrepresented in clinical trials, in whom long term follow-up data is lacking. It is unknown if traditional measures of prognosis apply to this group of pts.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>2. Purpose</strong></span></span><br />
<span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Identify independent predictors of prognosis in oldest-old adults after admission in CICU.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>3. Methods</strong><br />
Unicentric, retrospective analysis of consecutive pts with &ge;80 years admitted in CICU, in an urgent setting, during 2018. Pts were evaluated regarding baseline characteristics specifically age and sex and background comorbidities, functional status (independent and partially dependent) and occurrence of in-hospital complications. A 4-years follow-up was performed. Variables associated with long-term mortality, re-admission and urgent evaluation were identified. Group comparison tests (Pearson&acute;s Chi2 and <em>t-tests</em>) as well as a Cox regression were used to identify independent predictors of long-term mortality.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>4. Results</strong><br />
A total of 104 pts with </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&ge;80 years </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">were admitted to the CICU</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">. The mean age was 83.9</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn;3.1 years</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">and </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">66.1% of pts were male.</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">44.2% of patients died during follow-up.</span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Group comparison tests</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> revealed partially dependent (p=.022), absence of HTA (p=.032), background of coronary artery (p=.012), cerebrovascular (p=.019) and major valvular disease (p=.003) to be associated with long-term mortality. Conversely, age (p=.238) and hospital complications (p=.694) were not associated with long-term mortality. Furthermore, Cox regression isolated autonomy as the sole predictor of long-term mortality (p=.035, OR 1.95, 95% CI 1.050-3.624), with clear and early distinction of survival curves.</span></span></p>

<p style="text-align:justify"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.6667px"><strong>5. Conclusion</strong></span></span><br />
<span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><span style="color:black">Our analysis revealed that in the group of the oldest-old pts admitted in a CICU, paradoxically, age at admission was not correlated with mortality at follow-up. One the other hand, functional status was the only independent predictor of mortality, with clear risk distinction between independent and dependent patients. Risk score and traditional variables of prognosis should be validated before use, in this subgroup of patients.&nbsp;</span></span></span></span></p>