Copyright © 2004 by the European Society of Cardiology.
Clinical research
Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure
a Department of Cardiology, The Heart Centre, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
b Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
c Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
Received January 2, 2004; revised June 24, 2004; accepted July 1, 2004 * Corresponding author. Tel.: +45 35 45 35 45; fax: +45 39 76 01 07 (E-mail: finng{at}dadlnet.dk).
AIMS: To describe the association between age and risk factors in patients hospitalised with congestive heart failure (CHF) and to determine the effect of age on mortality.
METHODS AND RESULTS: Consecutive patients admitted to 34 hospitals with CHF during a period of 2 years were registered. Mean age was 71.7±10.2 years, 60% were male and 63% were in NYHA class III–IV. Moderate to severe left ventricular (LV) systolic dysfunction was present in 41%. Short and long-term survival status was obtained after 30 days and 5–8 years, respectively. Older patients less frequently had LV systolic dysfunction, were under treated with ACE-inhibitors and were more often female. The prevalence of hypertension, diabetes and ischaemic heart disease increased with age, until the oldest age group (>80 years). Age was an independent predictor of short-term mortality (risk ratio (RR) per 10-year increase was 1.23 (95% CI 1.04–1.47)). Advancing age significantly increased long-term mortality (RR 1.55 (1.50–1.61)). Age interacted with the LV ejection fraction (P=0.003). In patients with LV systolic dysfunction, the RR per 10-year increase was 1.29 (1.19–1.39) whereas in patients with preserved systolic function the RR was 1.57 (1.43–1.72, multivariate analyses).
CONCLUSION: The clinical characteristics of CHF patients vary considerably with age. Elderly patients hospitalised with CHF face a very grave prognosis, particularly if their heart failure symptoms are caused by LV systolic dysfunction.
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