Prognosis of acute heart failure in patients followed up in nursing homes in Spain: Results from the RICA registry

Background: Patients with chronic diseases such as heart failure (HF) are at risk of hospital admission. We evaluated the impact of living in nursing homes (NH) on readmissions and all -cause mortality of HF patients during a one-year follow up. Methods: An observational and multicenter study from the Spanish National Registry of Heart Failure (RICA) was performed. We compared clinical and prognostic characteristics between both groups. Bivariate analyses were performed using Student's t -test and Tukey's method and a Kaplan-Meier survival at one-year follow up. A multivariate proportional hazards analysis of [Cox] regression by the conditional backward method was conducted for the variables being statistically significant related to the probability of death in the univariate. Results: There were 5644 patients included, 462 (8.2%) of whom were nursing home residents. There were 52.7% women and mean age was 79.7 +/- 8.8 years. NH residents had lower Barthel (74.07), Charlson (3.27), and Pfeiffer index (2.2), p < 0.001). Mean pro-BNP was 6686 pg/ml without statistical significance differences between groups. After 1 -year follow-up, crude analysis showed no differences in readmissions 74.7% vs. 72.3%, p = 0.292, or mortality 63.9% vs. 61.1%, p = 0.239 between groups. However, after controlling for confounding variables, NH residents had a higher 1 -year all -cause mortality (HR 1.153; 95% CI 1.011-1.317; p = 0.034). Kaplan-Meier analysis showed worse survival in nursing home residents (log -rank of 7.12, p = 0.008). Conclusions: Nursing home residents with heart failure showed higher one-year mortality which could be due to worse functional status, higher comorbidity, and cognitive deterioration. (c) 2023 Elsevier Espana, S.L.U. All rights reserved.