Key result
Octogenarian status in ADHF is linked to ~25% higher 1-year post-discharge mortality versus non-octogenarians.
Why the study?
ADHF is the main cause of hospitalization and death in octogenarians, but data on the 1-year post-discharge mortality rate were lacking.
Does being an octogenarian (≥80 years) increase 1-year mortality and alter prognostic predictors compared to non-octogenarians in patients with acute decompensated heart failure?
Cohort (n=1,246)
No
Does being an octogenarian (≥80 years) increase 1-year mortality and alter prognostic predictors compared to non-octogenarians in patients with acute decompensated heart failure?
Absolute Event Rate: 29.9% vs 23.9%
p-value: p=0.014
Octogenarians with acute decompensated heart failure have a higher 1-year post-discharge mortality rate than younger patients, with severe hypoalbuminemia and antiplatelet use serving as independent predictors of death.
Octogenarians with ADHF face higher 1-year mortality; hypothesis-generating for age-specific predictors before practice change.
BACKGROUND: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF. METHODS AND RESULTS: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians. CONCLUSIONS: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. When octogenarians with ADHF have severe hypoalbuminemia and antiplatelet agents, early nutritional and medical interventions after discharge may be important to improve the 1-year prognosis.
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Nishino et al. (2023) conducted a cohort in Acute decompensated heart failure (n=1,246). Age ≥ 80 years (Octogenarian) vs. Age < 80 years (Non-octogenarian) was evaluated on 1-year mortality rate after discharge (p=0.014). Octogenarians with acute decompensated heart failure had a significantly higher 1-year post-discharge mortality rate compared to non-octogenarians (29.9% vs. 23.9%, p=0.014).
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