INTRODUCTION Elderly patients hospitalized with heart failure (HF) have high mortality rates and requires specific evidence based theraphy, however there are few studies which have focused on patients older than 80 years hospitalized with HF. The aim of the present study is to evaluate the overall clinical characteristics, management, and in-hospital outcomes of elderly patients hospitalized with HF. METHODS Journey-HF study was conducted in 37 different centers in Turkey and recruited 1606 patients who were hospitalized with HF between September 2015 and September 2016. In this study, clinical profile of patients ≥ 80 years old and 65-79 years old hospitalized with HF were described and compared based on EF-related classification: HFrEF (HF with reduced ejection fraction), HFmrEF (HF with mid-range ejection fraction) and HFpEF (HF with preserved ejection fraction). RESULTS A total of 1034 elder patients (71.6% 65-79 years old and 28.4% ≥80 years old) were recruited. Of the 65-79 years old patients 67.4% had HFrEF, 16.2% had HFmrEF and 16.3% had HFpEF. Among patients ≥80 years old 61.6% had HFrEF, 15.6% had HmrEF and 22.8% had HFpEF. When compared with patients with HFrEF and HFmrEF, patients ≥80 years old with HFpEF were more likely to be older, have atrial fibrilation (AF), and less likely to have diabetes mellitus (DM), coronary artery disease (CAD) or to be recieving an angiotensin-converting enzyme inhibitor (ACEi) or beta blocker theraphy. When compared to patients 65-79 years old with HFpEF, patients ≥80 years with HFpEF had a higher rate of AF and less likely DM. Acute coronary syndrome was the most common precipitant factor for hospitalization in both age groups with HFrEF group. Arrhythmia was a major precipitant factor for hospitalization of patients ≥80 years old with HFpEF. Non-compliance with theraphy was a major problem of patients ≥80 years old with HFrEF. CONCLUSION Elderly patients with HFrEF, HFmrEF and HFpEF each had characterized unique patient profiles and the guideline recommended medications were less likely to be used in these patient populations. In hospital mortality rate is worrisome and reflects a need for more specific tretment strategy.

中文翻译：

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射血分数降低、中程和保留的心力衰竭住院老年患者的流行病学和临床特征

引言 因心力衰竭 (HF) 住院的老年患者死亡率高，需要特定的循证治疗，但是很少有研究关注 80 岁以上的 HF 住院患者。本研究的目的是评估老年 HF 住院患者的整体临床特征、管理和住院结果。方法 Journey-HF 研究在土耳其 37 个不同的中心进行，招募了 1606 名 2015 年 9 月至 2016 年 9 月期间因 HF 住院的患者。本研究中，≥80 岁和 65-79 岁的 HF 住院患者的临床特征基于 EF 相关分类进行描述和比较：HFrEF（射血分数降低的 HF），HFmrEF（射血分数中等的 HF）和 HFpEF（射血分数保留的 HF）。结果共招募了1034名老年患者（71.6% 65-79岁，28.4% ≥80岁）。在 65-79 岁的患者中，67.4% 患有 HFrEF，16.2% 患有 HFmrEF，16.3% 患有 HFpEF。在≥80 岁的患者中，61.6% 患有 HFrEF，15.6% 患有 HmrEF，22.8% 患有 HFpEF。与 HFrEF 和 HFmrEF 患者相比，≥ 80 岁的 HFpEF 患者更可能年龄较大、患有心房颤动 (AF)，并且不太可能患有糖尿病 (DM)、冠状动脉疾病 (CAD) 或接受血管紧张素转换酶抑制剂 (ACEi) 或 β 受体阻滞剂治疗。与 65-79 岁的 HFpEF 患者相比，≥ 80 岁的 HFpEF 患者的 AF 发生率更高，DM 的可能性更小。急性冠脉综合征是 HFrEF 组两个年龄组住院最常见的诱发因素。心律失常是 80 岁以上 HFpEF 患者住院的主要诱发因素。不依从治疗是 80 岁以上 HFrEF 患者的主要问题。结论 患有 HFrEF、HFmrEF 和 HFpEF 的老年患者各自具有独特的患者特征，指南推荐的药物不太可能用于这些患者群体。住院死亡率令人担忧，这反映了需要更具体的治疗策略。不依从治疗是 80 岁以上 HFrEF 患者的主要问题。结论 患有 HFrEF、HFmrEF 和 HFpEF 的老年患者各自具有独特的患者特征，指南推荐的药物不太可能用于这些患者群体。住院死亡率令人担忧，这反映了需要更具体的治疗策略。不依从治疗是 80 岁以上 HFrEF 患者的主要问题。结论 患有 HFrEF、HFmrEF 和 HFpEF 的老年患者各自具有独特的患者特征，指南推荐的药物不太可能用于这些患者群体。住院死亡率令人担忧，这反映了需要更具体的治疗策略。