Orthostatic hypotension and mortality in elderly frail patients: a retrospective cross-sectional study Academic Article uri icon

abstract

  • Abstract: Orthostatic hypotension (OH) is a common problem in theelderly age group, and some studies have reported an associationbetween OH and increased mortality. We evaluated possible associ-ationsbetweenOHandmortalityinaretrospectivestudyoffrailelderlypatients who came for a comprehensive geriatric assessment.The study included all patients 65 years who were assessed in theoutpatient Comprehensive Geriatric Assessment Unit. Data were col-lected from the computerized medical record, includingblood pressure,sociodemographic data, lifestyle, falls, pulse rate, body mass index,functionalandcognitivestatus,andcomorbidity.Dataonmortlaitywerealso collected.The study population consisted of 571 patients who underwentassessment over a 9-year study period. The mean age was83.7 6.1, 35.9% were males, and 183 (32.1%) were diagnosed withOH.SystolicOH(OHS)wasmorecommonthandiastolicOH(25.2%vs15.6%). In univariate analyses, OHS was associated with increasedoverallmortality.Overthefollow-upperiod,30.2%oftheOHSpatientsdiedcomparedwith22.3%(P¼0.037),butintheCoxmodelstherewasno statistically significant associations between OHS and overallmortality. In contrast, age, burden of comorbidity, a low high-densitylipoprotein level, and low creatinine clearance were independent pre-dictors of increased overall mortality.In a population of frail elderly patients with a high burden ofcomorbidity, OH was not an independent risk factor for overallmortality.(Medicine 94(24):e977)Abbreviations: AF = atrial fibrillations, BI = Barthel Index, BMI =body mass index, CCI = Charlson Comorbidity Index, CGAU =Comprehensive Geriatric Assessment Unit, CHF = congestive heartfailure, CVA = cerebrovascular accident, DM = diabetes mellitus,HDL-C = high-density lipoprotein-cholesterol, HR = hazard ratio,HTN = hypertension, IHD = ischemic heart disease, MMSE =Minimental State Examination, OARS-IADL = Older AmericansResources and Service Instrumental Activity of Daily Living, OH =orthostatic hypotension, OHD = diastolic orthostatic hypotension,OHN = orthostatic hypotension negative, OHP = orthostatichypotension positive, OHS = systolic orthostatic hypotension.

publication date

  • January 1, 2015