title: Management and 1 year outcome of oldest-old hospitalized heart failure patients: a subacute geriatric hospital survey.
abstract: BACKGROUND
  Guidelines are frequently under-implement in older patients with heart failure. Octogenerians are often excluded from clinical trials.
  
  
  OBJECTIVE
  To characterize the clinical profile of the oldest-old (age > or =80 years) heart failure patients hospitalized in a subacute geriatric hospital and to evaluate their management and 1 year outcome.
  
  
  METHODS
  Patient characteristics and in-hospital course were retrospectively collected. Diagnosis of heart failure was based mainly on clinical evaluation in addition to chest x-ray results and echocardiographic findings when available.
  
  
  RESULTS
  The study population comprised 96 consecutive unselected heart failure patients hospitalized from January to June 2003. The patients were predominantly women (67%), aged 85 +/- 5 years, fully dependent or frail with a high rate of comorbidities. Adherence to guidelines and useof recommended heart failure medications were poor. Their 1 year mortality was 57%. According to logistic regression analysis the predictor of lower 1 year mortality was higher body mass index (odds ratio 0.86, 95% confidence interval 0.78-0.96), and the predictor of higher 1 year mortality was high urea levels (OR 1.04, 95% CI 1.02-1.06).
  
  
  CONCLUSIONS
  Our study confirms that the managementof oldest-old heart failure patients hospitalized in a subactute geriatric hospital was suboptimal and their mortality was exceptionally high.
authors.affiliation: Department of Geriatrics, Shoham Medical Center, Pardes Hana, Israel. carolav@shoham.health.gov.il
authors.forename: Carola
authors.initials: C
authors.lastname: Vigder
authors.forename: Yoshua
authors.initials: Y
authors.lastname: Ben Israel
authors.forename: Simcha R
authors.initials: SR
authors.lastname: Meisel
authors.forename: Edward
authors.initials: E
authors.lastname: Kaykov
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
mesh_terms: D000203:Activities of Daily Living; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007297:Inpatients / Q000706:statistics & numerical data*; D007557:Israel / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors