Heart failure prognosis and management in over-80-year-old patients: data from a French national observational retrospective cohort

Purpose The aim of the study was to assess the impact of clinical characteristics and management on the mid- to long-term follow-up prognosis of unselected over-80-year-old patients hospitalized for a first heart failure (HF) episode in a real-life setting. Despite the increasing proportion of HF pa...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2015-02, Vol.71 (2), p.251-260
Main Authors: Vorilhon, Charles, Chenaf, Chouki, Mulliez, Aurélien, Pereira, Bruno, Clerfond, Guillaume, Authier, Nicolas, Jean, Frédéric, Motreff, Pascal, Citron, Bernard, Eschalier, Alain, Lusson, Jean-R, Eschalier, Romain
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biomedical and Life Sciences
Biomedicine
Child
Child, Preschool
Epidemiology
Female
France - epidemiology
Heart failure
Heart Failure - drug therapy
Heart Failure - epidemiology
Hospitalization - statistics & numerical data
Humans
Infant
Male
Medical prognosis
Middle Aged
Oldest old people
Pharmacoepidemiology and Prescription
Pharmacology
Pharmacology/Toxicology
Prognosis
Retrospective Studies
Young Adult
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Summary:Purpose The aim of the study was to assess the impact of clinical characteristics and management on the mid- to long-term follow-up prognosis of unselected over-80-year-old patients hospitalized for a first heart failure (HF) episode in a real-life setting. Despite the increasing proportion of HF patients over 80 years of age, the latter remain a poorly studied population. Methods Analysis was based on the EGB (“ Echantillon Généraliste des Bénéficiaires ”) database. A cohort comprising 1825 adult patients with a first admission for HF between 2009 and 2011 was created and followed until June 2013 for survival analysis. Results Over-80-year-old patients represented 53 % of this cohort, with a median follow-up of 18.6 (3.3–29.5) months. Only 5 % of patients over 80 years received an optimal treatment at discharge [combination of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB), beta-blockers (BB), and mineralocorticoid receptor antagonists (MRA)]. During the follow-up period, only BB prescription levels ( p  = 0.02) increased. In over-80-year-olds, in-hospital mortality was 12 % (range, 10–14) and survival was 62.8 % (59.6–65.7) and 48.7 % (45.4–51.9) at 12 and 24 months, respectively. On multivariate analysis, dyslipidemia [0.74 (0.58–0.94), p  = 0.02], vitamin K antagonists [0.55 (0.44–0.69), p  
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-014-1794-7