Sex-related bedside clinical variables associated with survival of older inpatients with heart failure.
BACKGROUND
Little is known about sex-related differences in factors affecting prognosis of heart failure (HF). We prospectively investigated the relationship between bedside clinical variables and survival of older females vs. males with HF.


METHODS
Included were consecutive unselected inpatients, age >/=60 years, admitted for various acute conditions. HF was chronic and of diverse etiologies. Follow-up extended up to 5 years. All-cause mortality was registered and statistically analyzed for association with in-hospital clinical variables.


RESULTS
Included were 162 females and 200 males. Survival rates were 52.4% and 59%, respectively, (P=0.1). Advanced age and renal dysfunction (RD) were associated with low survival in both sexes (P<0.03 and 0.02, P<0.001 and 0.01, respectively). An association with low survival was found with respect to; admission for pulmonary edema (P<0.02), using furosemide >/=80 mg/day (P<0.005) and severe HF [NYHA class III-IV (P<0.01)] in females, as well as for hypokalemia (P<0.03) and hypocalcemia (P<0.03) in males. On multivariate analysis RD (P<0.001), increasing age (P=0.008) and furosemide dosage >/=80 mg (P=0.02) were most significantly associated with low survival in females, while RD only was significantly associated with low survival in males (P=0.03).


CONCLUSIONS
Several clinical variables, which affect prognosis in older HF patients are sex-related and probably carry practical significance.
Cohen
Natan
N
Department of Internal Medicine F, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, 70300, Israel. internal6@asaf.health.gov.il
Ilgiyaev
Eduard
E
Almoznino-Sarafian
Dorit
D
Alon
Irena
I
Shteinshnaider
Miriam
M
Chachashvily
Shulamit
S
Modai
David
D
Gorelik
Oleg
O
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011654:Pulmonary Edema / Q000453:epidemiology; D012737:Sex Factors; D016019:Survival Analysis
D004232:Diuretics; D005665:Furosemide