title: Noncardiovascular death, especially infection, is a significant cause of death in elderly patients with acutely decompensated heart failure.
abstract: BACKGROUND
  Despite marked improvements in treatment strategies for heart failure (HF), the mortality rate of elderly patients with HF is still high. Detailed causes of death have not been fully understood.
  
  
  RESULTS
  We studied 459 consecutive patients with acute decompensated HF (ADHF) emergently admitted to our hospital from 2007 to 2011. Patients were divided into 2 groups: <75 years old (younger group; n = 225) and ≥75 years old (elderly group; n = 234). All-cause death, cardiovascular death, and noncardiovascular death were assessed as adverse outcomes. Compared with the younger group, the elderly group was characterized by a higher proportion of women and hypertensive patients and higher left ventricular ejection fraction. During a mean follow-up of 20.7 months, a total of 174 patients (37.9%) died. All-cause death was significantly higher in the elderly group than in the younger group (46.6% vs 28.9%; P < .0001), and this difference was caused by an increase in noncardiovascular deaths (20.9% vs 9.3%; P < .001), especially deaths due to infection (10.7% vs 4.0%; P < .01). Cardiovascular deaths did not differ between the 2 groups.
  
  
  CONCLUSIONS
  Noncardiovascular deaths, most of which were caused by infection, were frequent among elderly patients with ADHF.
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ueda
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan. Electronic address: rkawa@naramed-u.ac.jp.
authors.forename: Rika
authors.initials: R
authors.lastname: Kawakami
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Horii
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Sadanori
authors.initials: S
authors.lastname: Okada
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Nishida
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okayama
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan; Department of Regulatory Medicine for Blood Pressure, Nara Medical University, Nara, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Somekawa
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawata
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: First Department of Internal Medicine Nara Medical University, Nara, Japan; Department of Regulatory Medicine for Blood Pressure, Nara Medical University, Nara, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D003141:Communicable Diseases / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends; D012189:Retrospective Studies
keywords: ADHF; elderly; prognosis