PT  - JOURNAL ARTICLE
AU  - Clément Briet
AU  - Katrien Blanchart
AU  - Adrien Lemaître
AU  - Isabelle Roux
AU  - Kelly Lavergne
AU  - Amelia Rocamora
AU  - Mathieu Bignon
AU  - Pierre Ardouin
AU  - Remi Sabatier
AU  - Vincent Roule
AU  - Farzin Beygui
TI  - Bedside mental status and outcome in elderly patients admitted for acute coronary syndromes
AID  - 10.1136/heartjnl-2019-314978
DP  - 2019 Nov 01
TA  - Heart
PG  - 1635--1641
VI  - 105
IP  - 21
4099  - http://heart.bmj.com/content/105/21/1635.short
4100  - http://heart.bmj.com/content/105/21/1635.full
SO  - Heart2019 Nov 01; 105
AB  - Objective We investigated whether mental status assessed by simple bedside tests in elderly patients admitted for acute coronary syndromes (ACS) was associated with higher risk of mortality.Methods We used the data from a prospective, open, ongoing cohort of patients≥75 years old admitted for ACS to a tertiary centre. Cognitive impairment (CogI) was defined by delirium detected by the Confusion Assessment Method or an abnormal Mini Mental State Examination score. A Cox model adjusted on predefined correlates of mortality was used to assess the relationship between CogI and 1-year mortality.Results Six-hundred consecutive patients with mental status assessment within 48 hours after admission were included. CogI was identified in 172 (29%) patients among whom 153 (25.5%) had an abnormal Mini Mental State Evaluation and 19 (3.2%) delirium. Death occurred in 49 (28.6%) patients with and 43 (10.5%) patients without CogI at 1 year. There was a significant association between CogI and 1-year mortality (adjusted-HR 2.4, 95% CI 1.53 to 3.62), p<0.001) independent of other covariables. CogI was also independently associated with higher rates of in-hospital bleeding and mortality as well as 3-month rates of all-cause, cardiovascular-related and heart failure-related rehospitalisation.Conclusions CogI detected by simple bedside tests in patients≥75 admitted for ACS is associated with an increased risk of 1-year mortality and 3 month rehospitalisation independent of other correlates of poor outcome.