Characteristics, management, and predictors of 6-month mortality in very elderly patients admitted for decompensated heart failure.

Prado SALAMANCA-BAUTISTA; Rocío RUIZ-HUESO; Irene BRAVO-CANDELA; Miriam ROMERO-CORREA; Ana Belkis PORTO-PÉREZ; Luis Enrique CAJAMARCA-CALVA; Miguel OTERO-SOLER; Carlos Jiménez-de JUAN; Aída GIL-DÍAZ; Carmen ALEMÁN-LLANSÓ; Javier ABELLÁN-MARTÍNEZ; Francesc FORMIGA

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Characteristics, management, and predictors of 6-month mortality in very elderly patients admitted for decompensated heart failure.

Author: Prado SALAMANCA-BAUTISTA ¹ ; Rocío RUIZ-HUESO ¹ ; Irene BRAVO-CANDELA ¹ ; Miriam ROMERO-CORREA ² ; Ana Belkis PORTO-PÉREZ ³ ; Luis Enrique CAJAMARCA-CALVA ⁴ ; Miguel OTERO-SOLER ⁵ ; Carlos Jiménez-de JUAN ⁶ ; Aída GIL-DÍAZ ⁷ ; Carmen ALEMÁN-LLANSÓ ⁸ ; Javier ABELLÁN-MARTÍNEZ ⁹ ; Francesc FORMIGA ¹⁰
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1. Hospital Universitario Virgen Macarena, Dr. Fedriani, s/n, 41009 Sevilla, Spain.
2. Hospital General de Riotinto, Avda. de la Esquila, 5, 21660 Minas de Riotinto, Spain.
3. Hospital Universitario A Coruña, As Xubias, 84, 15006, A Coruña, Spain.
4. Hospital Universitari Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Spain.
5. Hospital Nuestra Señora de Sonsoles, Avda. Juan Carlos I, 05004, Ávila, Spain.
6. Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, s/n 41013, Sevilla, Spain.
7. Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena s/n, 35010, Las Palmas de Gran Canaria, Spain.
8. Hospital Universitari Vall d'Hebron, Pg. de la Vall d'Hebron, 08035, Barcelona, Spain.
9. Hospital Universitario de Móstoles, Dr. Luis Montes, s/n, 28935, Madrid, Spain.
10. Hospital Universitari de Bellvitge, Carrer de la Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Spain.
Collective Name:EPICTER Investigators group
Publication Type:Journal Article
From: Journal of Geriatric Cardiology 2025;22(9):802-811
CountryChina
Language:English
Abstract: BACKGROUND:Patients aged 85 years or older admitted for heart failure (HF) have increased enormously due to improved survival in this disease. However, few studies assess the characteristics, treatments, and prognosis of very elderly patients admitted for acute HF.
METHODS:This study is a retrospective analysis of the EPICTER registry, that included patients admitted for acute HF in 74 Spanish hospitals. For this analysis, a total of 1887 patients were included and divided into 2 groups: 85 years or older (very elderly, 680 patients) and those under 85 years.
RESULTS:Compared to patients < 85 years, very elderly patients were more frequently women, had more hypertension and disease cerebrovascular disease, and less presence of chronic obstructive pulmonary disease (COPD), diabetes, and acute myocardial infarction. There were no differences in symptoms, except for delirium, significantly more common in very elderly patients. Management of these patients was more conservative and died more than the younger ones (41% vs. 25%, P < 0.001). The predictor variables of mortality in very elderly patients were the presence of COPD and peripheral arterial disease, delirium, and estimated survival of less than 6 months assessed by the physician in charge of the patient care.
CONCLUSION:Very elderly patients admitted for HF differ from younger ones in comorbidities, management, and symptoms, and have higher mortality. The presence of delirium, peripheral arterial disease, and COPD worsen the prognosis in these patients and can help to adapt the therapeutic effort and place emphasis on adequate symptom control.