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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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