Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure.

Abstract

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. 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). 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.