Multidimensional Prognostic Index Based on a Comprehensive Geriatric Assessment Predicts Short-Term Mortality in Older Patients With Heart Failure

Background. Pro-inflammatory signaling is mediated by a variety of inflammatory mediators which can cause myocardial apoptosis, hypertrophia, and fibrosis, and also ultimately lead to adverse cardiac remodeling. This study aimed to assess the role of circulating leukocyte-based indices in predicting the short-term mortality in patients with heart failure with reduced ejection fraction (HFrEF). Methods. In a retrospective study, patients with HFrEF admitted to a tertiary referral center between January 2016 and January 2017 were recruited to this study. The association between neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dLNR = neutrophils/(leukocytes-neutrophils)), monocyte/granulocyte to lymphocyte ratio (MGLR = (white cell count-lymphocyte count) to lymphocyte count), platelet to lymphocyte ratio (PLR) and six-months mortality of patients were assessed. Results. A total of 197 patients with HFrEF were enrolled in the study. NLR (P<0.001), dNLR (P<0.001), MGLR (P<0.001), PLR (P=0.006) and LVEF (P=0.042) showed significant difference between survived and died patients. In the Cox multivariate analysis we did not find NLR, dLNR, MGLR or PLR as an independent predictor of short-term mortality in HFrEF patients. Conclusions. Although High NLR, PLR, MGLR and dNLR was associated with short-term mortality, it failed to independently predict the prognosis of HFrEF patients.

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The relevance of a multidomain geriatric assessment in older patients with heart failure

ESC Heart Failure ◽

10.1002/ehf2.12651 ◽

2020 ◽

Vol 7 (3) ◽

pp. 1264-1272

Author(s):

Emma E.F. Kleipool ◽

Julia H.I. Wiersinga ◽

Marijke C. Trappenburg ◽

Albert C. Rossum ◽

Carmen S. Dam ◽

...

Keyword(s):

Heart Failure ◽

Geriatric Assessment ◽

Older Patients ◽

Patients With Heart Failure

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Comprehensive geriatric assessment in older patients with cancer: an external validation of the Multidimensional Prognostic Index in a French prospective cohort study

10.21203/rs.2.18817/v1 ◽

2019 ◽

Author(s):

Chunyun Hu ◽

Marc Paccalin ◽

Simon Valero ◽

Amelie Jamet ◽

Thomas Brunet ◽

...

Keyword(s):

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Older Patients ◽

External Validation ◽

Prognostic Index ◽

Risk Groups ◽

University Hospital ◽

Patients With Cancer ◽

Cox Proportional Hazard Regression ◽

One Year

Abstract Background: Older patients with cancer require specific and individualized management. The Multidimensional Prognostic Index (MPI) based on the Comprehensive Geriatric Assessment (CGA) has shown a predictive interest in terms of mortality.Methods: From 2015 to 2017, consecutive patients ≥75 years old with cancer in Poitiers University Hospital referred to an oncogeriatric consultation. Patients underwent CGA with MPI that is categorized into three risk groups of mortality at one year.Results: Overall, 433 patients were included (women 42%; mean age 82.8±4.8 years). Most common tumor sites were prostate (23%), skin (17%), colorectum (15%) and breast (12%); 29% patients had a metastatic disease; 231 patients (53%) belonged to "MPI-1" group, 172 (40%) to "MPI-2" group and 30 patients (7%) were classified in "MPI-3" group. One-year mortality rate was 32% (23% in MPI-1, 41% in MPI-2 and 53% in MPI-3, p=0.024). All domains of MPI except cognition and living status were significantly associated with mortality at one-year, as well as tumor sites and metastatic status. Cox proportional hazard regression analysis, adjusted on age, gender, tumor sites and metastatic status, validated MPI as being associated with a higher mortality risk (p<0.0001). The prognostic value of MPI was confirmed by the area under the ROC curve at 0.826 (P <0.0001).Conclusion: Our study confirmed the predictive value of MPI for one-year mortality in older patients with cancer. This practical prognostic tool may help to optimize the management of these vulnerable patients.

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