Acute Heart Failure (AHF)-related hospitalizations and mortality are still high in western countries, especially among older patients. This study aimed to describe the clinical characteristics and predictors of in-hospital mortality of older patients hospitalized with AHF. We conducted a retrospective study including all consecutive patients ≥65 years who were admitted for AHF at a single academic medical center between 1 January 2008 and 31 December 2018. The primary outcome was all-cause, in-hospital mortality. We also analyzed deaths due to cardiovascular (CV) and non-CV causes and compared early in-hospital events. The study included 6930 patients, mean age 81 years, 51% females. The overall mortality rate was 13%. Patients ≥85 years had higher mortality and early death rate than younger patients. Infections were the most common condition precipitating AHF in our cohort, and pneumonia was the most frequent of these. About half of all hospital deaths were due to non-CV causes. After adjusting for confounding factors other than NYHA class at admission, infections were associated with an almost two-fold increased risk of mortality, HR 1.74, 95% CI 1.10–2.71 in patients 65–74 years (p = 0.014); HR 1.83, 95% CI 1.34–2.49 in patients 75–84 years (p = 0.001); HR 1.74, 95% CI 1.24–2.19 in patients ≥85 years (p = 0.001). In conclusion, among older patients with AHF, in-hospital mortality rates increased with increasing age, and infections were associated with an increased risk of in-hospital mortality. In contemporary patients with AHF, along with the treatment of the CV conditions, management should be focused on timely diagnosis and appropriate treatment of non-CV factors, especially pulmonary infections.

De Matteis, G., Covino, M., Burzo, M. L., Della Polla, D. A., Franceschi, F., Mebazaa, A., Gambassi, G., Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure, <<JOURNAL OF CLINICAL MEDICINE>>, 2022; 11 (2): 439-453. [doi:10.3390/jcm11020439] [http://hdl.handle.net/10807/200106]

Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure

De Matteis, Giuseppe
Co-primo
Investigation
;
Covino, Marcello
Co-primo
Formal Analysis
;
Franceschi, Francesco
Supervision
;
Gambassi, Giovanni
Supervision
2022

Abstract

Acute Heart Failure (AHF)-related hospitalizations and mortality are still high in western countries, especially among older patients. This study aimed to describe the clinical characteristics and predictors of in-hospital mortality of older patients hospitalized with AHF. We conducted a retrospective study including all consecutive patients ≥65 years who were admitted for AHF at a single academic medical center between 1 January 2008 and 31 December 2018. The primary outcome was all-cause, in-hospital mortality. We also analyzed deaths due to cardiovascular (CV) and non-CV causes and compared early in-hospital events. The study included 6930 patients, mean age 81 years, 51% females. The overall mortality rate was 13%. Patients ≥85 years had higher mortality and early death rate than younger patients. Infections were the most common condition precipitating AHF in our cohort, and pneumonia was the most frequent of these. About half of all hospital deaths were due to non-CV causes. After adjusting for confounding factors other than NYHA class at admission, infections were associated with an almost two-fold increased risk of mortality, HR 1.74, 95% CI 1.10–2.71 in patients 65–74 years (p = 0.014); HR 1.83, 95% CI 1.34–2.49 in patients 75–84 years (p = 0.001); HR 1.74, 95% CI 1.24–2.19 in patients ≥85 years (p = 0.001). In conclusion, among older patients with AHF, in-hospital mortality rates increased with increasing age, and infections were associated with an increased risk of in-hospital mortality. In contemporary patients with AHF, along with the treatment of the CV conditions, management should be focused on timely diagnosis and appropriate treatment of non-CV factors, especially pulmonary infections.
2022
Inglese
De Matteis, G., Covino, M., Burzo, M. L., Della Polla, D. A., Franceschi, F., Mebazaa, A., Gambassi, G., Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure, <<JOURNAL OF CLINICAL MEDICINE>>, 2022; 11 (2): 439-453. [doi:10.3390/jcm11020439] [http://hdl.handle.net/10807/200106]
File in questo prodotto:
File Dimensione Formato  
2022 - Clinical Predictors AHF.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 508.61 kB
Formato Adobe PDF
508.61 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/200106
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 7
social impact