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Background: Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. Material and methods: We performed a secondary analysis of the OAK-3 Registry including all consecutive patients >= 65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. Results: We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95% CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95% CI 1.1-9.0; p = .033) compared to normal nutritional status. Conclusions: The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.

Objective: To assess the value of frailty screening tool (Identification of Senior at Risk [ISAR]) in predicting 30-day mortality risk in older patients attended in emergency department (ED) for acute heart failure (AHF). Design: Observational multicenter cohort study. Setting: OAK-3 register. Subjects: Patients aged >= 65 years attended with ADHF in 16 Spanish EDs from January to February 2016. Intervention: No. Variables: Variable of study was ISAR scale. The outcome was all-cause 30-day mortality. Results: We included 1059 patients (mean age 85 +/- 5,9 years old). One hundred and sixty (15.1%) cases had 0-1 points, 278 (26.3%) 2 points, 260 (24.6%) 3 points, 209 (19.7%) 4 points, and 152 (14.3%) 5-6 points of ISAR scale. Ninety five (9.0%) patients died within 30 days. The percentage of mortality increased in relation to ISAR category (lineal trend P value < .001). The area under curve of ISAR scale was 0.703 (95%Cl 0.655-0.751; P

PurposeTo study patient profile, fall-related characteristics and immediate outcomes according to age and to determine the effect of age in the outcomes among older patients presenting to ED after a fall.MethodsCross-sectional analysis of the FALL-ER registry that included patients aged 65years old that presented to five Spanish EDs after a fall. Patients were classified into three age categories, and demographic, comorbidity, chronic medication, fall-related characteristics, health care resources and immediate outcomes data were analysed.ResultsWe included 1610 patients, 541 (28%) aged 65-74, 647 (40.2%) aged 74-84 and 512 (31.8%) aged 85years old. Indoor falls, with no witnesses, at night and due to non-identified causes were significantly more likely among the oldest old. Medications related to risk of falling and antithrombotic therapy significantly increased with age category. Physical, functional and psychological consequences and healthcare resource use increased significantly with age group. Age was independently associated with severe injury (adjusted OR 1.02; IC 95% 1.01-1.04), fear of falling (adjusted OR 1.02; IC 95% 1.01-1.04) and acute functional impairment (adjusted OR 1.02; IC 95% 1.00-1.04).ConclusionsIndoor falls, with no witnesses, at night and due to non-identified causes were significantly more likely among the oldest old. The probability of presenting with severe injury, fear of falling and acute functional impairment increases with age.