Key result
Age ≥80 years linked to ~9-point higher in-hospital mortality in hospitalized heart failure.
Why the study?
Octogenarians and older patients constitute a growing subgroup of heart failure patients, yet data comparing their clinical profile with younger patients remain limited.
Does age ≥80 years increase in-hospital mortality compared to age <80 years in patients hospitalized for heart failure?
Cross-Sectional (n=2,227)
Does age ≥80 years increase in-hospital mortality compared to age <80 years in patients hospitalized for heart failure?
Octogenarians hospitalized for heart failure present with a distinct clinical and echocardiographic phenotype, higher prevalence of HFpEF, and significantly higher in-hospital mortality (30.9% vs. 22.0%) compared to younger patients.
Supports closer monitoring of octogenarians hospitalized with HF; leaves open whether age-specific interventions narrow the mortality gap.
Background Heart failure (HF) in older adults is characterized by distinct clinical presentation and outcomes. Octogenarians and older patients constitute a growing subgroup, yet data comparing their clinical profile with younger HF patients remain limited. Purpose The aim of this study was to compare clinical characteristics and in-hospital mortality between octogenarians and younger patients hospitalized for HF. Methods This cross-sectional study analyzed 2,227 consecutive patients hospitalized for HF. Patients were divided into two groups according to age: <80 years and ≥80 years. Clinical characteristics, laboratory parameters, echocardiographic findings, and in-hospital mortality were compared between the groups. Results Octogenarians accounted for 488 patients (21.9%) of the cohort. Compared with younger patients, octogenarians had a higher proportion of females (47.9% vs. 31.1%, p<0.001). They more frequently presented with advanced NYHA functional class (NYHA IV: 69.9% vs. 60.9%, p<0.001) and dyspnea (58.6% vs. 50.6%, p=0.002), but less often had fatigue and peripheral edema. Octogenarians had higher prevalence of hypertension and atrial fibrillation, but lower prevalence of diabetes. They had higher levels of inflammatory and renal biomarkers, including CRP, urea, creatinine, troponin and NT-proBNP (all p<0.001), and lower hemoglobin levels (p<0.001). Echocardiography revealed smaller left ventricular dimensions and volumes, higher left ventricular ejection fraction and lower tricuspid annular plane systolic excursion in octogenarians (all p<0.001). Octogenarians more frequently had HFpEF (33.4% vs. 20.8%, p<0.001). In-hospital mortality was higher in octogenarians (30.9% vs. 22.0%, p<0.001). Conclusion Octogenarians exhibit a distinct HF phenotype with worse outcomes and specific clinical and echocardiographic characteristics, supporting the need for age-adjusted management strategies.
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Preveden et al. (2026) conducted a cross-sectional in Heart failure (n=2,227). Age ≥80 years (octogenarians) vs. Age <80 years was evaluated on In-hospital mortality (p=<0.001). Octogenarians hospitalized with heart failure had significantly higher in-hospital mortality compared with patients <80 years (30.9% vs. 22.0%, p<0.001).
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