Vol.:(0123456789) 1 3 Aging Clin Exp Res DOI 10.1007/s40520-017-0853-1 ORIGINAL ARTICLE High comorbidity, measured by the Charlson Comorbidity Index, associates with higher 1-year mortality risks in elderly patients experiencing a frst acute heart failure hospitalization Francesc Formiga 1  · Rafael Moreno-Gonzalez 1  · David Chivite 1  · Jonathan Franco 2  · Abelardo Montero 1  · Xavier Corbella 1,3   Received: 30 October 2017 / Accepted: 4 November 2017 © Springer International Publishing AG, part of Springer Nature 2017 independent predictor of mid-term post-discharge mortal- ity among elderly HF patients. Keywords Heart failure · Comorbidity · Hospitalization · Mortality Introduction Heart failure (HF) is a clinical syndrome associated with sig- nifcant morbidity and mortality [1]. This is especially true among elderly HF patients, who represent the majority of HF cases [2]. Managing HF in the presence of cardiovascu- lar and non-cardiovascular comorbidities is particularly chal- lenging, and their presence has been identifed as a major prognostic indicator for increasing mortality, complications and resource utilization [3, 4]. The infuence of comorbidity in HF patients can be evalu- ated focusing on individual diseases or syndromes (anemia, chronic kidney failure and diabetes), or as a whole using comorbidity indexes. The Charlson Comorbidity Index (CCI) is validated, widely known and commonly used in many settings as a predictive tool for mortality estimation [5, 6]. However, there are few studies analyzing the value of clustering comorbidity indexes in HF patients, and the few conducted using the CCI have focused on chronic HF outpa- tients [7, 8]. Few information evaluated the infuence of the CCI as a survival prediction tool (at 30 days and 1 year) for patients newly hospitalized with acute HF (AHF) with data derived from retrospective administrative database review, with few information available regarding the characteristics of the patients’ HF and the AHF episode [9]. To further address the prognostic role of the CCI, we developed the present study to investigate whether a high mortality burden relates to mid-term (1 year) post-discharge Abstract Background Comorbidity is related to poor health results in chronic heart failure (HF). Aims The purpose of the study was to assess whether a high Charlson Comorbidity Index score (CCI) relates to 1 year mortality after a frst hospitalization for acute HF (AHF). Methods We reviewed the medical records of 897 patients > 65 years of age admitted within a two-year period because of a frst episode of AHF. We analyzed two groups: low (CCI ≤ 2) and high (CCI > 2) comorbidity. Results Patients’ mean CCI was 2.2 ± 1.7; 344 patients (38.35%) had a CCI > 2. 1-year all-cause mortality rate in the high comorbidity group was 32.6%, worse than that among low comorbidity group patients (23.7%, p = 0.002). Cox multivariate analysis identifed a CCI > 2 as an independent risk factor for 1-year mortality (p = 0.002; HR: 1.525; CI 95% 1.161–2.003), along with older age, history of arterial hypertension, and higher admission heart rate and serum potassium values. Analyzing CCI as a continuous variable, the association remained is also signifcant (p = 0.0001; HR 1.145; CI 95% 1.069–1.854). Conclusions Higher global comorbidity (CCI > 2) at the time of a frst hospitalization because of AHF is an * Francesc Formiga formiga@bellvitgehospital.cat 1 Geriatric Unit, Internal Medicine Department, Universitary Hospital Bellvitge-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain 2 Internal Medicine Service, Hospital Universitari Quiron Dexeus, Barcelona, Spain 3 Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain