Prognostic Factors of Adverse Events in Acute Heart Failure in Older Adults

Abstract

Objective: Acute heart failure (AHF) is a severe and prevalent disease, especially in older adults. The primary objective of our study was to identify the impact of geriatric factors on adverse events (increased length of hospitalization, death during hospitalization, or transfer to another acute unit) during hospitalization for AHF. The second objective was to identify the impact of geriatric factors on not returning home after hospitalization. Methods: In this retrospective multicenter study in France, older adults ≥ 75 years old hospitalized in 4 different acute geriatric units in Marseille for AHF from January 2018 to December 2019 were included. All the included patients were identified according to the Program for Medicalization of Information Systems (PMSI) coding, with the main diagnosis of AHF being referred to as the “principal diagnosis”. Results: A total of 187 patients with AHF were included. The mean age was 88.2 years (± 5.5), and 69.5% were women. The death rate was 9.6%, and the length of stay was increased for 41.7% of patients. In multivariate analysis, adverse events significantly increased in patients with functional impairment and bedsores. The odds of an unfavorable follow-up after hospitalization significantly increased in patients with mood disorders and functional impairment. Conclusion: Our study highlighted functional impairment, mood disorders, and bedsores as factors that impacted adverse events and unfavorable follow-up after hospitalization in patients managed for AHF. These geriatric domains should be considered in the management of AHF to improve survival, functional status, and the number of older patients who return home after hospitalization.