Characteristics and in-hospital mortality of elderly patients with heart failure in Spanish hospitals
Alberto Esteban-Fernández1
Manuel Anguita-Sánchez2
Juan Luis Bonilla-Palomas3
María Anguita-Gámez4
María García5
José Luis Bernal6
Náyade Del Prado5
Cristina Fernández-Pérez7
Julián Pérez-Villacastin4
Juan José Gómez-Doblas8
Francisco Javier Elola5
1.Cardiology Department,Hospital Universitario Severo Ochoa,Madrid,Spain2.Cardiology Department,Hospital Uni-versitario Reina Sofía,Córdoba,Spain3.Cardiology Department,Hospital San Juan de la Cruz,úbeda,Spain4.Cardiology Department,Hospital Clínico San Carlos,Madrid,Spain5.Fundación Instituto para la Mejora de la Asistencia Sanitaria,Madrid,Spain6.Fundación Instituto para la Mejora de la Asistencia Sanitaria,Madrid,Spain;Management Control Department,Hospital Universitario 12 de Octubre,Madrid,Spain7.Fundación Instituto para la Mejora de la Asistencia Sanitaria,Madrid,Spain;Department of Preventive Medicine,área Sanitaria de Santiago de Compostela y Barbanza,Instituto de Investigación de Santiago,San-tiago de Compostela,Spain8.Cardiology Department,Hospital Universitario Virgen de la Victoria,Málaga,Spain
摘要：BACKGROUND The prevalence of heart failure (HF) increases with age, and it is one of the leading causes of hospitalization and death in older patients. However, there are little data on in-hospital mortality in patients with HF ≥ 75 years in Spain. METHODS A retrospective analysis of the Spanish Minimum Basic Data Set was performed, including all HF episodes dischar-ged from public hospitals in Spain between 2016 and 2019. Coding was performed using the International Classification of Disea-ses, 10th Revision. Patients ≥ 75 years with HF as the principal diagnosis were selected. We calculated: (1) the crude in-hospital mort-ality rate and its distribution according to age and sex; (2) the risk-standardized in-hospital mortality ratio; and (3) the associa-tion between in-hospital mortality and the availability of an intensive cardiac care unit (ICCU) in the hospital. RESULTS We included 354,792 HF episodes of patients over 75 years. The mean age was 85.2 ± 5.5 years, and 59.2％ of patients were women. The most frequent comorbidities were renal failure (46.1％), diabetes mellitus (35.5％), valvular disease (33.9％), card-iorespiratory failure (29.8％), and hypertension (26.9％). In-hospital mortality was 12.7％, and increased with age [odds ratio (OR) =1.07, 95％ CI: 1.07–1.07, P < 0.001] and was lower in women (OR = 0.96, 95％ CI: 0.92–0.97, P < 0.001). The main predictors of mortal-ity were the presence of cardiogenic shock (OR = 19.5, 95％ CI: 16.8–22.7, P < 0.001), stroke (OR = 3.5, 95％ CI: 3.0–4.0, P < 0.001) and advanced cancer (OR = 2.6, 95％ CI: 2.5–2.8, P < 0.001). In hospitals with ICCU, the in-hospital risk-adjusted mortality tended to be lower (OR = 0.85, 95％ CI: 0.72–1.00, P = 0.053). CONCLUSIONS In-hospital mortality in patients with HF ≥ 75 years between 2016 and 2019 was 12.7％, higher in males and eld-erly patients. The main predictors of mortality were cardiogenic shock, stroke, and advanced cancer. There was a trend toward lo-wer mortality in centers with an ICCU.
机标关键词：characteristicsspanishheartwithelderlyfailurehospitalsin-hospital
论文发表日期：2023-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 247-255 )