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Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry

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Abstract

The objective of this study is to determine the prevalence of cognitive impairment (CogI) in patients hospitalized for congestive heart failure, and the influence of CogI on mortality and hospital readmission. This is a multicenter cohort study of patients hospitalized for congestive heart failure enrolled in the RICA registry. The patients were divided into 3 groups according to their Short Portable Mental Status Questionnaire score: 0–3 errors (no CogI or mild CogI), 4–7 (moderate CogI) and 8–10 (severe CogI). A total of 3845 patients with a mean (SD) age of 79 (8.6) years were included; 2038 (53%) were women. A total of 550 (14%) patients had moderate CogI and 76 (2%) had severe CogI. Factors independently associated with severe CogI were age (OR 1.09, 95% CI 1.05–1.14 p < 0.001), male sex (OR 0.57, 95% CI 0.34–0.95, p = 0.031), heart rate (OR 1.01, 95% CI 1.00–1.02, p = 0.004), Charlson index (OR 1.16, 95% CI 1.06–1.27, p = 0.002), and history of stroke (OR 2.67, 95% CI 1.60–4.44, p < 0.001). Severe CogI was associated with higher mortality after one year (HR 3.05, 95% CI 2.25–4.14, p < 0.001). The composite variable of death/hospital readmission was higher in patients with CogI (log rank p < 0.001). Patients with heart failure and severe CogI are older and have a higher comorbidity burden, lower survival, and a higher rate of death or readmission at 1 year, compared to patients with no CogI.

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Acknowledgements

We gratefully acknowledge all investigators who form part of the RICA Registry. We would like to thank RICA’s Registry Coordinating Center “S&H Medical Science Service” for their quality control data, logistic support, and administrative work and Prof. Salvador Ortiz, Universidad Autónoma de Madrid and Statistical Advisor S&H Medical Science Service, for the statistical analysis of the data presented in this paper. The authors declare that there are no conflicts of interest.

RICA Registry Members

Arévalo-Lorido JC, Carrascosa S, Carrera Izquierdo M, Cepeda JM, Conde-Martel A, Díaz de Castellví S, Díez-Manglano J, Formiga F, García Bruñén JM, García Escrivá D, González Franco A, León Acuña A, Llàcer P, López-Castellanos G, Lorente Furió O, Manzano L, Montero-Pérez-Barquero M, Moreno Palanco MA, Povar Echeverria M, Quesada Simón MA, Roca Villanueva B, Romero Requena JM, Ruiz Ortega R, Salamanca Bautista MP, Soler Rangel ML, Trullàs JC, Vázquez Ronda MA.

Funding

This work was supported by an educational unrestricted scholarship granted by Novartis.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Hospital Miguel Servet, Saragossa, Spain

    José Miguel García Bruñén & Marina Povar Echeverria

  2. Department of Internal Medicine, Hospital Royo Villanova, Avda San Gregorio nº 30, 50015, Saragossa, Spain

    Jesús Díez-Manglano

  3. EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute, Saragossa, Spain

    Jesús Díez-Manglano

  4. Department of Internal Medicine, University Hospital Ramón y Cajal, University of Alcalá (IRYCIS), Madrid, Spain

    Luis Manzano

  5. Department of Internal Medicine, Hospital d’Olot i comarcal de la Garrotxa, Olot, Girona, Spain

    Joan Carles Trullàs

  6. Universitat de Vic – Universitat Central de Catalunya, Vic, Barcelona, Spain

    Joan Carles Trullàs

  7. Department of Internal Medicine, Hospital Perpetuo Socorro, Badajoz, Spain

    Jorge Manuel Romero Requena

  8. Department of Internal Medicine, University Hospital Virgen Macarena, Seville, Spain

    Mª Prado Salamanca Bautista

  9. Department of Internal Medicine, University Hospital Central de Asturias, Oviedo, Spain

    Álvaro González Franco

  10. Department of Internal Medicine, Hospital Vega Baja, Orihuela, Alicante, Spain

    José María Cepeda Rodrigo

  11. Department of Internal Medicine, IMIBIC/Hospital Reina Sofía, University of Córdoba, Córdoba, Spain

    Manuel Montero-Pérez-Barquero

Authors
  1. José Miguel García Bruñén
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  2. Marina Povar Echeverria
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  4. Luis Manzano
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  7. Mª Prado Salamanca Bautista
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  8. Álvaro González Franco
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  9. José María Cepeda Rodrigo
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  10. Manuel Montero-Pérez-Barquero
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Consortia

RICA Investigators Group

Corresponding author

Correspondence to Jesús Díez-Manglano.

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Conflict of interest

The authors state that they have no conflict of interests.

Human and animal rights

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its amendments. The study was approved by the Ethics Committee for Clinical Research of Reina Sofia Universitary Hospital in Cordoba, Spain.

Informed consent

All patients, or their caregivers in case of cognitive impairment, gave an informed consent.

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We included the member of RICA Investigators Group in Acknowledgement section.

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García Bruñén, J.M., Povar Echeverria, M., Díez-Manglano, J. et al. Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry. Intern Emerg Med 16, 141–148 (2021). https://doi.org/10.1007/s11739-020-02400-5

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  • DOI: https://doi.org/10.1007/s11739-020-02400-5

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