Clinical characteristics of heart failure associated with functional dependence at admission in hospitalized elderly.

The study was cross-sectional, so it measured heart-failure features and dependence at the same time; it cannot show which came first or that a feature caused dependence. It was done in one cardiology hospital in São Paulo with a convenience sample, so it may not apply to other settings or patients. Prior dependence for the week before admission was estimated retrospectively, not observed during that week. The authors note that a larger sample would have allowed adjustment for confounding variables, and the analysis examined many clinical features. Most symptoms were self-reported, and older patients may underreport or adapt to symptoms.

Do not read the odds ratios as proof that treating breathlessness, leg swelling, cough, chest pain or crackling will prevent dependence. The study measured dependence at admission in one hospital and did not follow patients or test any treatment.