Heart failure in Korean elderly patients - clinical features, prognosis and prognostic factors

Heart failure (HF) is very common in the elderly but there are not sufficie nt data about the clinical characteristics and prognostic factors of HF amo ng the Asian elderly patients. The aim of the study was to find out the cli nical characteristics, survival, and prognostic factors of HF in Korean eld erly patients. Among elderly patients admitted from February 1995 to Februa ry 1998, the patients with a discharge diagnosis of HF were enrolled. Throu gh the medical record review, the diagnosis was confirmed and clinical para meters to affect survival were identified. Total number of the subjects was 104 [age: 77 +/- 7 years (65-96), male:female = 36:68, follow-up duration: 20 +/- 14 months, LVEF: 46 +/- 16%]. Ischemic heart disease (IHD) was the most common cause of HF (42%) followed by valvular heart disease (28%), and hypertension (20%). The 1-year survival rate was 71.3%. Advanced age [risk ratio (RR): 1.41 per 5 years of age; 95% CI: 1.11-1.80] and reduced left v entricular ejection fraction (0.69 per 10%, 0.52-0.93), poor initial functi onal class (2.40, 1.15-5.00), diabetes (2.79, 1.30-5.97) and past history o f HF (2.37, 1.10-5.10) badly affected the survival rates. When the Cox prop ortional hazard model was applied for multivariate analysis, only aging (1. 64 per 5 years of age, 1.19-2.28) and diabetes (4.92, 1.83-13.23) predicted poor prognosis. Twenty-seven percent of the patients had diastolic HF (LVE F > 45%, LVEDD < 55 mm) who had higher survival rates with marginal signifi cance (0.35? 0.10-1.17, P = 0.09). (C) 1999 Elsevier Science Inland Ltd. Al l rights reserved.