[Impaired cognitive function as an independent risk factor for the in-hospital mortality in the elderly with chronic...

Heart failure (HF) and impaired cognitive function are frequent causes of hospitalization in elderly patients. Independently, both clinical syndromes are associated with increased mortality. The aim of the study was to evaluate the influence of impaired cognitive function on in-hospital mortality in old patients with HF. A modified Mini-Mental State Exam (MMMSE) was performed in 598 consecutive patients (65-102 years old; 355 female) with heart failure. All patients were stratified into low (6.3 +/- 1.2 points), medium (19.7 +/- 4.7 points) or high (29.1 +/- 2.1 points) tertile group according to MMMSE results. Total in-hospital mortality was 52.0% in the lowest, 34.2% in the medium and 15.1% in the highest tertile (Pearson Chi-square p < 0.0001 for trend). The comparison of in-hospital mortality between tertiles of MMMSE was done with the use of logistic regression adjusted to age, sex, and the presence of diabetes mellitus, renal failure and anemia. Comparison of in-hospital mortality between patients from the lowest tertile of MMSE with the highest one revealed that odds ratio was 5.93 (95% CI: 3.58-9.80; p < 0.0001) whereas it was 2.67 (95% CI: 1.60-4.67; p = 0.0002) for patients from the medium tertile. The obtained results show that the worse cognitive function is, the worse in-hospital prognosis can be observed in older patients with HF. Moreover, it also suggests that impaired cognitive function may be an independent risk factor for mortality in elderly HF patients.