Prognostic Comparison of Octogenarian vs. Non-Octogenarian With Acute Decompensated Heart Failure　― AURORA Study

Background: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the...

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Published in:Circulation Journal 2023/12/25, Vol.88(1), pp.103-109
Main Authors: Nishino, Masami, Egami, Yasuyuki, Kawanami, Shodai, Abe, Masaru, Ohsuga, Mizuki, Nohara, Hiroaki, Ukita, Kohei, Kawamura, Akito, Yasumoto, Koji, Tsuda, Masaki, Okamoto, Naotaka, Matsunaga-Lee, Yasuharu, Yano, Masamichi
Format: Article
Language:English
Subjects:
Acute decompensated heart failure
Aftercare
Aged, 80 and over
Albumin
Antiplatelet agents
Heart Failure
Humans
Octogenarians
Patient Discharge
Platelet Aggregation Inhibitors
Prognosis
Risk Factors
Stroke Volume
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Summary:Background: Acute decompensated heart failure (ADHF) is the main cause of hospitalization and death of octogenarians, but no data on the 1-year post-discharge mortality rate. We evaluated the clinical status and predictors of 1-year mortality in octogenarians with ADHF.Methods and Results: From the AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital) study, we examined 1,246 hospitalized ADHF patients. We compared the in-hospital mortality rate and the proportion of heart failure (HF) with preserved ejection fraction (HFpEF) between octogenarians and non-octogenarians. After discharge we compared the 1-year mortality rate between these groups, and we also evaluated the predictors of death in both groups. The proportion of HFpEF among the in-hospital deaths of octogenarians was significantly higher than in non-octogenarians (46.2% vs. 15.0%, P=0.031). The 1-year mortality rate after discharge was significantly higher in the octogenarians than non-octogenarians (P=0.014). Multivariable Cox regression analysis revealed that albumin ≤3.0 g/dL and antiplatelet agents were useful predictors of 1-year death after discharge of octogenarians whereas chronic kidney disease was a predictor in the non-octogenarians.Conclusions: The proportion of HFpEF among in-hospital deaths of octogenarians with ADHF was high as compared with non-octogenarians. When octogenarians with ADHF have severe hypoalbuminemia and antiplatelet agents, early nutritional and medical interventions after discharge may be important to improve the 1-year prognosis.
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-23-0470