Watanabe Yusuke, Tajiri Kazuko, Nagata Hiroyuki, Kojima Masayuki
Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, 3033-3 Tagouchichou, Hitachiomiya, Ibaraki 319-2601, Japan.
Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan.
J Clin Med. 2021 Apr 2;10(7):1468. doi: 10.3390/jcm10071468.
Heart failure is one of the leading causes of mortality worldwide. Several predictive risk scores and factors associated with in-hospital mortality have been reported for acute heart failure. However, only a few studies have examined the predictors in elderly patients. This study investigated determinants of in-hospital mortality in elderly patients with acute heart failure, aged 80 years or above, by evaluating the serum sodium, blood urea nitrogen, age and serum albumin, systolic blood pressure and natriuretic peptide levels (SOB-ASAP) score. We reviewed the medical records of 106 consecutive patients retrospectively and classified them into the survivor group ( = 83) and the non-survivor group ( = 23) based on the in-hospital mortality. Patient characteristics at admission and during hospitalization were compared between the two groups. Multivariate stepwise regression analysis was used to evaluate the in-hospital mortality. The SOB-ASAP score was significantly better in the survivor group than in the non-survivor group. Multivariate stepwise regression analysis revealed that a poor SOB-ASAP score, oral phosphodiesterase 3 inhibitor use, and requirement of early intravenous antibiotic administration were associated with in-hospital mortality in very elderly patients with acute heart failure. Severe clinical status might predict outcomes in very elderly patients.
心力衰竭是全球主要的死亡原因之一。关于急性心力衰竭，已有多项预测风险评分以及与院内死亡率相关的因素被报道。然而，仅有少数研究对老年患者的预测因素进行了考察。本研究通过评估血清钠、血尿素氮、年龄、血清白蛋白、收缩压和利钠肽水平（SOB - ASAP）评分，调查了80岁及以上急性心力衰竭老年患者院内死亡的决定因素。我们回顾性分析了106例连续患者的病历，并根据院内死亡率将他们分为存活组（n = 83）和非存活组（n = 23）。比较了两组患者入院时及住院期间的特征。采用多因素逐步回归分析评估院内死亡率。存活组的SOB - ASAP评分显著优于非存活组。多因素逐步回归分析显示，SOB - ASAP评分差、使用口服磷酸二酯酶3抑制剂以及需要早期静脉应用抗生素与高龄急性心力衰竭患者的院内死亡率相关。严重的临床状态可能预测高龄患者的预后。
