title: [Outcomes of elderly patients admitted to hospital due to severe aortic stenosis and rejected for surgical intervention].
abstract: BACKGROUND
  The natural outcome of untreated severe symptomatic aortic stenosis in the elderly patient is extremely poor. In this analysis we studied the clinical, ultrasound and analytical variables, that could be associated with the vital prognosis in this patient sub-group.
  
  
  METHODS
  A retrospective study of patients admitted to our hospital between 2004 and 2008 due to symptoms associated with the presence of a severe aortic stenosis and were not considered for surgery. Demographic, concomitant diseases, ultrasound (ejection fraction, transvalvular gradient, valve area) and laboratory analytical data (haemoglobin, creatinine, atrial natriuretic peptide) were analysed and the logistic euroscore was calculated.
  
  
  RESULTS
  A total of 49 patients were included (73.5% women), with a mean age of 82.2±5.5 years. The median follow up was 396.0 days, interquartile range 99.5-731.0 days, with a mortality of 75.5%. In the multivariate analysis, only the left ventricular ejection fraction measured by ultrasound was an important predictor as regards life expectancy (EF 35-50%: HR 3.74, IC 95% CI; 1.11-12.65, P=0.034; EF<35%: HR 6.76, IC 95% CI; 1.86-24.52, p=0.004).
  
  
  CONCLUSIONS
  The life expectancy of elderly patients with untreated severe symptomatic aortic stenosis is very limited, with a high mortality during the first year. The ejection fraction is significantly associated with the prognosis in these patients.
authors.affiliation: Unidad de Cardiología, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España. gabrielretegui@msn.com
authors.forename: Gabriel
authors.initials: G
authors.lastname: Retegui García de Quesada
authors.forename: Sandra
authors.initials: S
authors.lastname: Ogalla Vera
authors.forename: Rocío Pérez
authors.initials: RP
authors.lastname: de la Yglesia
authors.forename: Manuel
authors.initials: M
authors.lastname: Cobo Cabello
authors.forename: Jesús
authors.initials: J
authors.lastname: Marín Morgado
authors.forename: Mariano
authors.initials: M
authors.lastname: Ruiz Borrell
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D016079:Refusal to Treat; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome