Clinical characteristics and in-hospital mortality of very elderly patients hospitalized for acute decompensated heart failure: experience at a single cardiovascular centre in Japan

Objective The number of elderly patients with heart failure (HF) has increased. We aimed to determine the clinical characteristics and in-hospital mortality of very elderly patients hospitalized for acute HF. Methods and results In total, 403 consecutive patients (median [interquartile range] age 79 [70, 85] years [y]) who were hospitalized between September 2009 and March 2011 to a single cardiovascular centre in Kitakyushu, one of the most ageing metropolitan cities in Japan, were enrolled.The 2012 ESC guideline for acute HF was used for the diagnosis.The patients were divided into two groups: patients of age >= 85 y (n = 108, group 1) and those of age <85 y (n =295, group 2). Group 1 patients were characterized with statistical significance by a female predominance, higher prevalence of hypertension, lower prevalence of diabetes and chronic obstructive lung disease, lower estimated glomerular filtration rate (eGFR) and haemoglobin levels, and a higher left ventricular ejection fraction. In-hospital, all-cause mortality was significantly higher in group 1 patients (11.1% vs 4.4%, P <0.05). Higher age, lower systolic blood pressure on admission, and lower eGFR were independently associated with mortality. Incidence of survival within 30 days was lower in group 1 than in group 2 patients (hazard ratio 0.31, 95% confidence interval 0.12 to 0.83, P = 0.02). Conclusions In an ageing metropolis of Japan, very elderly patients comprised nearly a quarter of acute HF hospitalizations and had a lower 30-day survival rate compared with less elderly patients.