Prevalence of comorbidities and the prognostic value of the PROFUND index in a hospital cardiology unit

M A López-Garrido; I Antequera Martín-Portugués; V M Becerra-Muñoz; H N Orellana-Figueroa; F J Sánchez-Lora; L Morcillo-Hidalgo; M F Jiménez-Navarro; J J Gómez-Doblas; E de Teresa-Galván; J M García-Pinilla

doi:10.1016/j.rce.2016.10.007

Prevalence of comorbidities and the prognostic value of the PROFUND index in a hospital cardiology unit

Rev Clin Esp (Barc). 2017 Mar;217(2):87-94. doi: 10.1016/j.rce.2016.10.007. Epub 2016 Nov 28.

[Article in English, Spanish]

Affiliations

¹ Unidad de Gestión Clínica del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, España. Electronic address: milopga@gmail.com.
² Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España.
³ Unidad de Gestión Clínica del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, España.

PMID: 27908447
DOI: 10.1016/j.rce.2016.10.007

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 1,033 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; Comorbilidades; Heart failure; Insuficiencia cardiaca; Multiple diseases; PROFUND index; Pluripatología; Prognosis; Pronóstico; Índice PROFUND.