Identification of Senior At Risk scale predicts 30-day mortality among older patients with acute heart failure

Abstract

OBJECTIVE: To assess the value of frailty screening tool (Identification of Senior at Risk [ISAR]) in predicting 30-day mortality risk in older patients attended in emergency department (ED) for acute heart failure (AHF).

DESIGN: Observational multicenter cohort study.

SETTING: OAK-3 register.

SUBJECTS: Patients aged ≥65 years attended with ADHF in 16 Spanish EDs from January to February 2016.

INTERVENTION: No.

VARIABLES: Variable of study was ISAR scale. The outcome was all-cause 30-day mortality.

RESULTS: We included 1059 patients (mean age 85±5,9 years old). One hundred and sixty (15.1%) cases had 0-1 points, 278 (26.3%) 2 points, 260 (24.6%) 3 points, 209 (19.7%) 4 points, and 152 (14.3%) 5-6 points of ISAR scale. Ninety five (9.0%) patients died within 30 days. The percentage of mortality increased in relation to ISAR category (lineal trend P value <.001). The area under curve of ISAR scale was 0.703 (95%CI 0.655-0.751; P<.001). After adjusting for EFFECT risk categories, we observed a progressive increase in odds ratios of ISAR scale groups compared to reference (0-1 points).

CONCLUSIONS: scale is a brief and easy tool that should be considered for frailty screening during initial assessment of older patients attended with AHF for predicting 30-day mortality.