Geriatric Unit, Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Internal Medicine Department, Hospital Universitari Quiron Dexeus Universitary Hospital, Barcelona, Spain.
Geriatr Gerontol Int. 2019 Mar;19(3):184-188. doi: 10.1111/ggi.13580. Epub 2018 Dec 12.
To assess whether 1-year mortality in older patients experiencing a first admission for acute heart failure was related to sex, and to explore differential characteristics according to sex.
We reviewed the medical records of 1132 patients aged >70 years of age admitted within a 3-year period because of a first episode of acute heart failure. We analyzed sex differences. Mortality was assessed using multivariate Cox analysis.
There were 648 (57.2%) women (mean age 82.1 years) and 484 men (mean age 80.1 years). There were some differences in risk factors: women more often had hypertension, and less frequently had coronary heart disease and comorbidities (women more often had dementia, and men more often had chronic obstructive pulmonary disease, chronic kidney disease and stroke). Women were treated more frequently with spironolactone. The 1-year all-cause mortality rate was 30.2% (30.7% women and 29.5% men). Multivariate Cox analysis identified an association between reduced heart failure (hazard ratio [HR] 0.35, 95% confidence interval [95% CI] 0.21-0.59), hemoglobin <10 g/dL (HR 1.99, 95% CI 1.16-3.40), systolic blood pressure (HR 0.98, 95% CI 0.97-0.99), previous diagnosis of dementia (HR 2.07, 95% CI 1.12-3.85), number of chronic therapies (HR 1.12, 95% CI 1.05-1.19) and 1-year mortality in women. In men, an association with mortality was found for low systolic blood pressure (HR 0.97, 95% CI 0.97-0.98) and higher potassium values (HR 1.42, 95% CI 1.01-2.00).
Among older patients hospitalized for the first acute heart failure episode, there is a slightly higher predominance of women. There are sex differences in risk factors and comorbidities. Although the mortality rate is similar, the factors associated with it according to sex are different. Geriatr Gerontol Int 2019; 19: 184-188.
评估首次因急性心力衰竭入院的老年患者 1 年死亡率是否与性别有关，并探讨根据性别差异的特征。
我们回顾了 3 年内因首次急性心力衰竭入院的 1132 名年龄＞70 岁的患者的病历。我们分析了性别差异。使用多变量 Cox 分析评估死亡率。
648 名（57.2%）女性（平均年龄 82.1 岁）和 484 名男性（平均年龄 80.1 岁）。危险因素存在一些差异：女性更常患有高血压，较少患有冠心病和合并症（女性更常患有痴呆，男性更常患有慢性阻塞性肺疾病、慢性肾脏病和中风）。女性更常使用螺内酯治疗。1 年全因死亡率为 30.2%（女性 30.7%，男性 29.5%）。多变量 Cox 分析确定了心力衰竭减轻（危险比 [HR] 0.35，95%置信区间 [95%CI] 0.21-0.59）、血红蛋白＜10 g/dL（HR 1.99，95%CI 1.16-3.40）、收缩压（HR 0.98，95%CI 0.97-0.99）、先前诊断为痴呆（HR 2.07，95%CI 1.12-3.85）、慢性治疗次数（HR 1.12，95%CI 1.05-1.19）和女性 1 年死亡率之间存在关联。在男性中，低收缩压（HR 0.97，95%CI 0.97-0.98）和较高钾值（HR 1.42，95%CI 1.01-2.00）与死亡率相关。
在因首次急性心力衰竭入院的老年患者中，女性略占优势。危险因素和合并症存在性别差异。尽管死亡率相似，但根据性别，与死亡率相关的因素不同。老年医学与老年健康杂志 2019; 19: 184-188。
