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RESEARCH PRODUCT
Clinical profile and 1-year clinical outcomes of super elderly patients admitted with acute heart failure
Gema MiñanaAmparo VillaescusaMiguel LorenzoRaquel HerediaClara SastreJulio NúñezRafael De La EspriellaAdriana ConesaEduardo NúñezEnrique SantasJose CiveraGonzalo NúñezAnna MollarAntoni Bayes-genisClara Bonanadsubject
Malemedicine.medical_specialty030204 cardiovascular system & hematologyVentricular Function Left03 medical and health sciences0302 clinical medicineInternal medicineInternal MedicineHumansMedicine030212 general & internal medicineChildAgedAged 80 and overHeart FailureEjection fractionbusiness.industryFemale sexStroke VolumeMean ageMiddle AgedPrognosismedicine.diseaseHospitalizationIncreased riskHeart failureCohortFemalebusinessAll cause mortalitydescription
There is scarce information about the clinical profile and prognosis of acute heart failure (AHF) at the extreme ranges of age. We aimed to evaluate the 1-year death (all-cause mortality and HF-death) and HF-rehospitalizations of patients ≥85 years admitted for AHF.We prospectively evaluated a cohort of 3054 patients admitted with AHF from 2007 to 2018 in a third-level center. Age was categorized per 10-year categories (65 years; 65-74 years, 75-84 years, and ≥85 years). The risk of mortality and HF-rehospitalizations across age categories was evaluated with Cox regression analysis and Cox regression adapted for competing events as appropriate.The mean age was 73.6 ± 11.2 years, 48.9% were female, and 52.8% had preserved left ventricular ejection fraction (HFpEF). A total of 414 (13.6%) patients were ≥85 years. Among this group of age, female sex and HFpEF phenotype were more frequent. At 1-year follow-up 667 all-cause deaths (22,1%), 311 HF-deaths (10.1%) and 693 HF-hospitalizations (22,7%) were recorded. After multivariable adjustment, and compared to patients65 years, a stepwise increased risk of all-cause mortality and HF-death was found for each decade increase in age, especially for patients ≥85 years (HR=3.47; 95% CI: 2.49 - 4.84, p0.001, HR=3.31; 95% CI: 1.95 - 5.63; p0.001, respectively). This subgroup of patients also showed an increased risk of HF-rehospitalization (HR=1.58; 95% CI: 1.16 - 2.16, p=0.004).Super elderly patients admitted with AHF showed a dramatically increased risk of 1-year death. This subset of patients also shown an increased risk of 1-year HF-readmission.
year | journal | country | edition | language |
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2020-03-27 | European Journal of Internal Medicine |