期刊论文详细信息
Journal of Clinical Medicine
Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
Alexandre Mebazaa1  Giuseppe De Matteis2  Giovanni Gambassi2  Davide Antonio Della Polla3  Marcello Covino3  Francesco Franceschi3  Maria Livia Burzo4 
[1] Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, 75010 Paris, France;Division of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;Emergency Department, Ospedale Generale M.G. Vannini, Istituto Figlie di San Camillo, 00177 Rome, Italy;
关键词: heart failure;    internal medicine;    older patients;    pulmonary infections;    sepsis;    mortality;   
DOI  :  10.3390/jcm11020439
来源: DOAJ
【 摘 要 】

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.

【 授权许可】

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