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January 10, 2026Russian Open Medical Journal1 citationsOpen Access

Factors Associated with Mortality in Patients with Chronic Heart Failure During an 18-Month Follow-up Period

ОРО. А. РубаненкоARAnatoly O. RubanenkoDDD. V. Duplyakov

Key Result

Age, NYHA functional class IV, and LVEF <40% were significant predictors of mortality in CHF patients over 18 months, with 33.5% dying during follow-up.

Key Points

  • To identify factors influencing mortality risk in patients with chronic heart failure over an 18-month period.
  • Included 591 patients registered in the Samara Region CHF Registry.
  • Conducted multivariate analysis on various clinical factors.
  • Follow-up lasted 18 months to assess mortality rates.
  • 198 (33.5%) patients died during the follow-up.
  • Age and NYHA functional class IV significantly increased mortality risk.
  • Previous cardiac surgery was associated with lower mortality risk.
  • Left ventricular ejection fraction < 40% was a strong predictor of death.

Structured PICO

P
Population
591 patients with chronic heart failure (CHF) registered in the Samara Region CHF Registry at 60 medical facilities. Median age 71.0 years, 57.4% men. Key inclusion criteria: signs and symptoms of NYHA functional classes III and IV CHF and at least one additional feature (e.g., >1 hospitalization for HF in the previous 365 days, dialysis, or ICD/CRT/pacemaker).
O
Outcome
All-cause mortality over an 18-month follow-up periodhard clinical

In patients with chronic heart failure, older age, NYHA class IV, pleural effusion, outpatient oxygen therapy, inpatient inotropic therapy, and LVEF <40% were identified as predictors of 18-month mortality, while previous cardiovascular surgery was protective.

Limitations

  • Registry-based design with potential systematic errors
  • Did not assess levels of some laboratory parameters like NT-proBNP
  • Did not analyze the treatment strategy

Abstract

Background — Chronic heart failure (CHF) is one of the leading causes of mortality. Many factors can influence the risk of mortality in patients with CHF. Therefore, it is necessary to clarify the predictors of mortality in patients with CHF. The goal of our study was to identify predictors of adverse prognosis in patients with CHF. Methods — The study included 591 patients with CHF at 60 medical facilities registered in Samara Region CHF Registry during one month in 2022. Their median age was 71.0 (64.0-80.0) years, and 339 (57.4%) of them were men. The follow-up period lasted 18 months, during which 198 (33.5%) patients died. Results — According to the results of multivariate analysis, prognostic factors associated with mortality in patients with CHF were age (OR 1.024, 95% confidence interval CI 1.007-1.042, p=0.006), NYHA functional class IV (OR 2.226, 95% CI 1.358-3.649, p=0.002), pleural effusion (OR 1.423, 95% CI 0.973-2.083, p=0.069), oxygen therapy in outpatient settings (2.401, 95% CI 0.963-5.988, p=0.06), inotropic therapy in a hospital settings (OR 1.559, 95% CI 0.924-2.630, p=0.096), and left ventricular ejection fraction (LVEF) < 40% (OR 1.580, 95% CI 1.066-2.342, p=0.023). Previous cardiac surgery was inversely associated with the probability of death (OR 0.476, 95% CI 0.3-0.755, p=0.002). The area under the ROC curve, corresponding to the relationship between mortality and the value of the logistic regression function, was 0.691 (p=0.023) (95% CI 0.645-0.736). Conclusion — Predictors of mortality in patients with CHF over an 18-month follow-up period include age, NYHA functional class IV CHF, pleural effusion, oxygen therapy in outpatient settings, inotropic therapy in a hospital setting, and LVEF < 40%. Previous cardiovascular surgeries had a favorable effect on mortality in these patients.

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Cite This Study

Рубаненко et al. (2025) studied this question. Age, NYHA functional class IV, and LVEF <40% were significant predictors of mortality in CHF patients over 18 months, with 33.5% dying during follow-up.

synapsesocial.com/papers/6963221091e05aa366cb881bhttps://doi.org/10.15275/rusomj.2025.0409
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