Cargando…

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

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 retrospecti...

Descripción completa

Detalles Bibliográficos
Autores principales: De Matteis, Giuseppe, Covino, Marcello, Burzo, Maria Livia, Della Polla, Davide Antonio, Franceschi, Francesco, Mebazaa, Alexandre, Gambassi, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781633/
https://www.ncbi.nlm.nih.gov/pubmed/35054133
http://dx.doi.org/10.3390/jcm11020439
_version_ 1784638126216445952
author De Matteis, Giuseppe
Covino, Marcello
Burzo, Maria Livia
Della Polla, Davide Antonio
Franceschi, Francesco
Mebazaa, Alexandre
Gambassi, Giovanni
author_facet De Matteis, Giuseppe
Covino, Marcello
Burzo, Maria Livia
Della Polla, Davide Antonio
Franceschi, Francesco
Mebazaa, Alexandre
Gambassi, Giovanni
author_sort De Matteis, Giuseppe
collection PubMed
description 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.
format Online
Article
Text
id pubmed-8781633
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87816332022-01-22 Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure De Matteis, Giuseppe Covino, Marcello Burzo, Maria Livia Della Polla, Davide Antonio Franceschi, Francesco Mebazaa, Alexandre Gambassi, Giovanni J Clin Med Article 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. MDPI 2022-01-15 /pmc/articles/PMC8781633/ /pubmed/35054133 http://dx.doi.org/10.3390/jcm11020439 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Matteis, Giuseppe
Covino, Marcello
Burzo, Maria Livia
Della Polla, Davide Antonio
Franceschi, Francesco
Mebazaa, Alexandre
Gambassi, Giovanni
Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title_full Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title_fullStr Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title_full_unstemmed Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title_short Clinical Characteristics and Predictors of In-Hospital Mortality among Older Patients with Acute Heart Failure
title_sort clinical characteristics and predictors of in-hospital mortality among older patients with acute heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781633/
https://www.ncbi.nlm.nih.gov/pubmed/35054133
http://dx.doi.org/10.3390/jcm11020439
work_keys_str_mv AT dematteisgiuseppe clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT covinomarcello clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT burzomarialivia clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT dellapolladavideantonio clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT franceschifrancesco clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT mebazaaalexandre clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure
AT gambassigiovanni clinicalcharacteristicsandpredictorsofinhospitalmortalityamongolderpatientswithacuteheartfailure