Total illness burden strongly predicts heart failure death
A very high illness complexity score had a hazard ratio of 4.99 for death, compared with 1.33 for reduced heart pumping ability, across 149,703 patients.
Limit: Patients were tracked over only a single year of follow-up
Edited by Boris Djordjevic · AgingResearch.News
Researchers evaluated 149,703 patients with heart failure in Catalonia who had a median age of 81 years and were 53.6% women, in a population-based observational study. Socioeconomic status was low or very low in 71.1% of the patients, and their median time since diagnosis was 3.96 years. The study tracked deaths during 2024 to compare heart pumping function against Adjusted Morbidity Groups, a measure of overall illness burden and medical complexity based on diagnoses and prescriptions.
In multivariable models, a very high morbidity score was the strongest predictor of death from any cause, linked to a hazard ratio of 4.99. In comparison, reduced left ventricular ejection fraction, a measure of the heart's pumping capacity, was linked to a hazard ratio of 1.33. Age over 65 years was linked to a hazard ratio of 1.70, while female sex was linked to a hazard ratio of 0.79.
Why it matters
Heart failure predominantly affects older adults, who frequently accumulate multiple chronic medical conditions alongside cardiac dysfunction. The findings suggest that evaluating an older patient's total illness burden rather than organ function alone may help guide clinical care and population health strategies in aging populations.
Caveats
The observational design relied on health system records over a single year of follow-up and cannot show whether treating specific conditions changes survival. In addition, all participants lived in Catalonia and had a median age of 81, so the results may not apply to younger people or those in different healthcare settings.
The paper
Beyond LVEF: morbidity burden (GMA) as the main predictor of mortality and outcomes in heart failure
