First Department of Internal Medicine Nara Medical University, Nara, Japan.
First Department of Internal Medicine Nara Medical University, Nara, Japan.
J Card Fail. 2014 Mar;20(3):174-80. doi: 10.1016/j.cardfail.2013.12.007. Epub 2013 Dec 18.
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.
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.
Noncardiovascular deaths, most of which were caused by infection, were frequent among elderly patients with ADHF.
尽管心力衰竭（HF）的治疗策略有了显著改善，但老年 HF 患者的死亡率仍然很高。详细的死亡原因尚未完全了解。
我们研究了 2007 年至 2011 年期间因急性失代偿性 HF（ADHF）紧急入院的 459 例连续患者。患者分为 2 组：<75 岁（年轻组；n = 225）和≥75 岁（老年组；n = 234）。将全因死亡、心血管死亡和非心血管死亡评估为不良结局。与年轻组相比，老年组女性和高血压患者比例较高，左心室射血分数较高。在平均 20.7 个月的随访期间，共有 174 名患者（37.9%）死亡。老年组的全因死亡率明显高于年轻组（46.6% vs 28.9%；P <.0001），这种差异是由于非心血管死亡的增加（20.9% vs 9.3%；P <.001），特别是感染导致的死亡（10.7% vs 4.0%；P <.01）。两组之间的心血管死亡率没有差异。
非心血管死亡在 ADHF 的老年患者中较为常见，其中大部分是由感染引起的。
