Cognitive impairment in patients hospitalized for congestive heart failure. Data from the RICA Registry

Abstract

Objectives: 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. Methods: 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). Results: A total of 3,845 patients with a mean 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). Lower survival at 1 year was associated with higher CogI (log rank p<0.001). The composite variable of death/hospital readmission was higher in patients with CogI (log rank p<0.001). Conclusions: Patients with heart failure and severe CogI are older and have a higher comorbidity burden, worse functional capacity, lower survival, and a higher rate of death or readmission at 1 year, compared to patients with no CogI.