Fujii Noriyuki, Naito Kazuyuki, Nakahara Norifumi, Nakano Atsushi, Takagi Satoru
Department of Cardiology Sapporo Social Insurance General Hospital Sapporo Hokkaido Japan.
Acute Med Surg. 2014 Mar 5;1(2):76-82. doi: 10.1002/ams2.23. eCollection 2014 Apr.
The number of elderly patients with heart failure is increasing in Japan owing to the increase in the aging population. In the field of emergency medicine, the treatment and management of elderly patients with heart failure are key issues. We aimed to clarify the clinical characteristics and outcomes of these patients.
We enrolled 72 consecutive patients (age, 76.5 ± 12.5 years) with heart failure who were admitted to our hospital between January 1 and December 31, 2010. The characteristics and outcomes of super-elderly patients aged >85 years ( = 21) were compared with those of patients aged ≤85 years ( = 51).
The overall prevalence of chronic atrial fibrillation was high (43.1%). Underlying diseases, left ventricular function, renal function, in-hospital mortality, hospital stay period, and major complications were similar between the two groups. The super-elderly group had a significantly higher mortality rate and lower event-free survival rate after discharge (log-rank test, = 0.0018 and = 0.0032, respectively).The incidence of readmission for heart failure recurrence was 55.0% in the super-elderly group and 25.0% in the younger group.
There were no significant differences in the background characteristics and in-hospital treatment between super-elderly heart failure patients and younger patients. High mortality and cardiovascular event rates after discharge were observed in the super-elderly group.
由于老龄人口增加，日本老年心力衰竭患者数量正在上升。在急诊医学领域，老年心力衰竭患者的治疗和管理是关键问题。我们旨在阐明这些患者的临床特征和预后。
我们纳入了2010年1月1日至12月31日期间连续入住我院的72例心力衰竭患者（年龄76.5±12.5岁）。将年龄>85岁的超高龄患者（n=21）的特征和预后与年龄≤85岁的患者（n=51）进行比较。
慢性心房颤动的总体患病率较高（43.1%）。两组患者的基础疾病、左心室功能、肾功能、院内死亡率、住院时间和主要并发症相似。超高龄组出院后的死亡率显著较高，无事件生存率较低（对数秩检验，P分别为0.0018和0.0032）。超高龄组因心力衰竭复发再次入院的发生率为55.0%，较年轻组为25.0%。
超高龄心力衰竭患者与较年轻患者在背景特征和院内治疗方面无显著差异。超高龄组出院后死亡率和心血管事件发生率较高。
