Acute heart failure in patients over 70 years of age: Precipitating factors of decompensation

作者：Dominguez J P^*; Harriague C M; Garcia Rojas I; Gonzalez G; Aparicio T; Gonzalez Reyes A

来源：Revista Clinica Espanola, 2010, 210(10): 497-504.

DOI：10.1016/j.rce.2010.04.020

• Heart failure
• Heart decompensation
• Elderly
• Hospital mortality

Objectives: Heart failure decompensation is the most common reason for hospitalization in persons over 65 years old. There is limited information on the prevalence of precipitating factors of heart failure decompensation in this population. In this study we prospectively examined the factors associated with decompensation of heart failure in patients over 70 years of age.
Material and methods: During the 36 months from January 2006 to December 2008, we included 386 patients over 70 years of age that were admitted through emergencies with these three criteria: Dyspnea (class III or IV of the New Yourk Heart Association), pulmonary edema and echocardiographic data of left ventricular systolic or diastolic dysfunction.
Results: The mean age of the patients was 82 years and 58.5% were female. Left ventricular systolic dysfunction was diagnosed in 41.2% of them. We identified one or more precipitating factors of heart failure decompensation in 89.6% of the patients. The most common were atrial tachyarrhythmia (22.3%), respiratory infection (21.2%), severe anemia (17.1%), acute renal failure (12.7%), severe hypoalbuminemia (11.4%) and acute coronary syndrome (9.1%). Fifty-two patients (13.5%) died. The variables independently associated with hospital mortality were acute renal failure, severe hypoalbuminemia, systolic blood pressure <110 mmHg, white blood cell count >10.000 per mm(3) and valvular heart disease.
Conclusions: In most patients over 70 years of age hospitalized with acute heart failure it is possible to identify one or more precipitating factors of decompensation, some of which are independently associated with hospital mortality.

• 出版日期2010-11