title: Predictors of long-term (4-year) mortality in elderly and young patients with acute heart failure.
abstract: OBJECTIVE
  The present study was designed to identify and compare predictors of short- and long-term mortality in elderly and young patients hospitalized with acute heart failure (HF).
  
  
  RESULTS
  The risk of in-hospital, 1- and 4-year mortality was assessed among 2336 acute HF patients in a prospective national survey. Interaction-term analysis was utilized to identify and compare independent risk factors between elderly (>75 years [n = 1182]) and younger (< or =75 years [n = 1154]) study patients. Elderly patients exhibited a 1.8-fold (P = 0.004), 1.4-fold (P < 0.001), and 1.7-fold (P < 0.001) increase in the adjusted risk of in-hospital, 1-year, and 4-year mortality, respectively, as compared with younger patients. Independent risk factors for 4-year mortality among elderly patients included NYHA functional Class III-IV before admission (HR = 1.46, P < 0.001), systolic blood pressure <115 mmHg (HR = 1.45, P = 0.002), renal dysfunction ([eGFR < 60 mL/min/1.73 m(2)] HR = 1.35, P = 0.002), diabetes mellitus (HR = 1.28, P = 0.006), and anaemia (HR = 1.25, P = 0.012). In the young group, but not in the elderly group, left ventricle ejection fraction (LVEF) <50% and hyponatraemia (sodium <136 mmol/L) were significant predictors of 4-year mortality. (LVEF <50%, HR = 1.47 for the young and 1.04 for the elderly, P for interaction = 0.025; hyponatraemia HR = 1.59 for the young and 1.17 for the elderly, P for interaction = 0.035).
  
  
  CONCLUSIONS
  Elderly patients exhibit different risk factors for long-term mortality as compared with young patients with acute HF. In contrast to younger patients, mortality risk in the older population is not decreased among those with preserved LVEF.
authors.affiliation: Heart Institute, Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. alon.barsheshet@heart.rochester.edu
authors.forename: Alon
authors.initials: A
authors.lastname: Barsheshet
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.forename: Eytan
authors.initials: E
authors.lastname: Cohen
authors.forename: Moshe
authors.initials: M
authors.lastname: Garty
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.forename: Amir
authors.initials: A
authors.lastname: Sandach
authors.forename: Solomon
authors.initials: S
authors.lastname: Behar
authors.forename: Eyal
authors.initials: E
authors.lastname: Zimlichman
authors.forename: Basil S
authors.initials: BS
authors.lastname: Lewis
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left