Key result
Age >75 predicts ~155% higher long-term mortality in hospitalized HF.
Why the study?
Heart failure is the leading cause of hospitalization for aging populations in Western countries and shows increasing mortality, motivating an assessment of long-term mortality risk factors in hospitalized patients.
Cohort (n=202)
Effect estimate: HR 2.55 (95% CI 1.56-4.15)
p-value: p=<0.001
Clinical factors such as advanced age, cognitive impairment, and elevated creatinine independently predict in-hospital and long-term mortality in patients hospitalized for heart failure.
May refine HF risk stratification; hypothesis-generating and should not yet change practice.
BACKGROUND: Heart failure (HF) is the leading cause of hospitalization for aging populations in Western countries, and is showing an increasing mortality. The aim of this study was to assess the probable long-term mortality risk factors for patients admitted because of HF. METHODS: Retrospective study of a cohort of 202 patients consecutively hospitalized because of HF and followed up for a maximum period of 5 years. Clinical and epidemiological factors and their relationship to in-hospital and long-term mortality were analyzed. RESULTS: In-hospital mortality was 16%.The independent predictors were: age >75 years (HR?=?2.68, 95%?IC: 1.65-4.36, p?=?0.001); cognitive impairment (HR?=?2.77, 95%?IC: 1.40-5.48, p?=?0.004); Barthel index =60 (HR?=?0.54, 95%?IC: 0.37-0.78, p?=?0,009); creatinine levels >1.16 mg/dl at admission (HR?=?1.57, 95%?IC: 1.12-2.20, p?=?0.009); and number of diagnostics >10 on discharge (HR?=?1. 64, 95%?IC: 1.14-2.36, p?=?0.007). Accumulated mortality at 12, 24, 36 and 48 months after hospital discharge were 43%, 51%, 67% and 70%, respectively; the independent predictors for this were: age >75 years (HR?=?2.55, 95%?IC: 1.56-4.15, p?<0.001); cognitive impairment (HR?=?2.45, 95%?IC: 1.22-4.90, p?=?0.011); creatinine levels >1.16 mg/dl on admission (HR?=?1.59, 95%?IC: 1.12-2.24, p?=?0.009); systolic blood pressure >140 mm Hg on admission (HR?=?0.56, 95%?IC: 0.40-0.80, p?<0.001); and number of diagnostics >10 on discharge (HR?=?1. 49, 95%?IC: 1.03-2.16, p?=?0.033). CONCLUSIONS: Clinical and epidemiological factors related to in-hospital and long-term mortality could help to improve the management of patients with HF.
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Valdivia-Marchal et al. (2020) conducted a cohort in Heart failure (n=202). Prognostic factors (e.g., age >75 years) was evaluated on Long-term mortality (HR 2.55, 95% CI 1.56-4.15, p=<0.001).
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