Randomized Controlled Trial Comparing a Multidisciplinary Intervention by a Geriatrician and a Cardiologist to Usual Care after a Heart Failure Hospitalization in Older Patients: The SENECOR Study

Marta Herrero-Torrus, Neus Badosa, Cristina Roqueta, Sonia Ruiz-Bustillo, Eduard Solé-González, Laia C Belarte-Tornero, Sandra Valdivielso-Moré, Olga Vázquez, Núria Farré, Marta Herrero-Torrus, Neus Badosa, Cristina Roqueta, Sonia Ruiz-Bustillo, Eduard Solé-González, Laia C Belarte-Tornero, Sandra Valdivielso-Moré, Olga Vázquez, Núria Farré

Abstract

Background: The prognosis of older patients after a heart failure (HF) hospitalization is poor.

Methods: In this randomized trial, we consecutively assigned 150 patients 75 years old or older with a recent heart failure hospitalization to follow-up by a cardiologist (control) or follow-up by a cardiologist and a geriatrician (intervention). The primary outcome was all-cause hospitalization at a one-year follow-up.

Results: All-cause hospitalization occurred in 47 of 75 patients (62.7%) in the intervention group and in 58 of 75 patients (77.3%) in the control group (hazard ratio, 0.67; 95% confidence interval, 0.46 to 0.99; p = 0.046). The number of patients with at least one HF hospitalization was similar in both groups (34.7% in the intervention group vs. 40% in the control group, p = 0.5). There were a total of 236 hospitalizations during the study period. The main reasons for hospitalization were heart failure (38.1%) and infection (14.8%). Mortality was 24.7%. Heart failure was the leading cause of mortality (54.1% of all deaths), without differences between groups.

Conclusions: A follow-up by a cardiologist and geriatrician in older patients after an HF hospitalization was superior to a cardiologist's follow-up in reducing all-cause hospitalization in older patients. (Funded by Beca Primitivo de la Vega, Fundación MAPFRE.

Clinicaltrials: gov number, NCT03555318).

Keywords: all-cause hospitalization; cardiologist; frailty; geriatrician; heart failure; prognosis.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
Kaplan–Meier curves for the primary endpoint, according to the study group.

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