Abstract
Background
In recent years, the population of very elderly heart failure (HF) patients has been rising, but there are few reports on their characteristics, treatment, and prognosis.
Methods This study included patients aged 18 years or older with acute HF admitted to a single hospital between April 1, 2016, and March 31, 2021. Patients were classified into three groups according to their echocardiographic left ventricular ejection fraction (LVEF): HF with reduced LVEF (LVEF < 40%: HFrEF), HF with mildly reduced LVEF (LVEF between 40% and 49%: HFmrEF), and HF with preserved LVEF (LVEF ≥ 50%: HFpEF).
Results
Of 524 admitted patients, 437 were discharged, including 124 with HFrEF, 62 with HFmrEF, and 251 with HFpEF. The median age was 86 years, and patients with HFmrEF and HFpEF were older than those with HFrEF. Overall, the in-hospital mortality rate was 14.1%, the 1-year composite event rate of cardiac death and heart failure readmission was 37.7%, and the 1-year all-cause death rate was 19.7%. In particular, the composite event rate was higher in patients with HFrEF than in those with HFpEF (44.0% vs. 32.8%, P = 0.03).
Conclusions
The high incidence of in-hospital mortality, composite events, and all-cause mortality in this very elderly population warrants prospective consideration of appropriate treatment choices and goal setting for these patients.