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

Abstract:

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 <110mmHg, white blood cell count >10.000 per mm³ 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.

journal_name

Rev Clin Esp

journal_title

Revista clinica espanola

authors

Domínguez JP,Harriague CM,García-Rojas I,González G,Aparicio T,González-Reyes A

doi

10.1016/j.rce.2010.04.020

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

497-504

issue

10

eissn

0014-2565

issn

1578-1860

pii

S0014-2565(10)00345-0

journal_volume

210

pub_type

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