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Clinical profile and 1-year clinical outcomes of super elderly patients admitted with acute heart failure

      Highlights

      • The information about the prognosis of patients hospitalized for acute heart failure (AHF) at extreme ranges of age is scarce.
      • The clinical profile of suprelderly patients with AHF commonly differs from younger patients.
      • Superelderly patients admitted for AHF showed and substantial increase of 1-year all-cause and heart failure death compared to younger patients. This excess of risk was also found for heart failure-readmission.

      Abstract

      Introduction

      There is scarce information about the clinical profile and prognosis of acute heart failure (AHF) at the extreme ranges of age. We aimed to evaluate the 1-year death (all-cause mortality and HF-death) and HF-rehospitalizations of patients ≥85 years admitted for AHF.

      Methods

      We prospectively evaluated a cohort of 3054 patients admitted with AHF from 2007 to 2018 in a third-level center. Age was categorized per 10-year categories (<65 years; 65-74 years, 75-84 years, and ≥85 years). The risk of mortality and HF-rehospitalizations across age categories was evaluated with Cox regression analysis and Cox regression adapted for competing events as appropriate.

      Results

      The mean age was 73.6 ± 11.2 years, 48.9% were female, and 52.8% had preserved left ventricular ejection fraction (HFpEF). A total of 414 (13.6%) patients were ≥85 years. Among this group of age, female sex and HFpEF phenotype were more frequent. At 1-year follow-up 667 all-cause deaths (22,1%), 311 HF-deaths (10.1%) and 693 HF-hospitalizations (22,7%) were recorded. After multivariable adjustment, and compared to patients <65 years, a stepwise increased risk of all-cause mortality and HF-death was found for each decade increase in age, especially for patients ≥85 years (HR=3.47; 95% CI: 2.49 – 4.84, p<0.001, HR=3.31; 95% CI: 1.95 – 5.63; p<0.001, respectively). This subgroup of patients also showed an increased risk of HF-rehospitalization (HR=1.58; 95% CI: 1.16 – 2.16, p=0.004).

      Conclusions

      Super elderly patients admitted with AHF showed a dramatically increased risk of 1-year death. This subset of patients also shown an increased risk of 1-year HF-readmission.

      Graphical abstract

      Keywords

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