Factors associated with hospitalizations for cardiovascular reasons in elderly outpatients with chronic heart failure


DOI: https://dx.doi.org/10.18565/therapy.2020.8.47-54

Larina V.N., Karpenko D.G., Mikhailusova M.P.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Purpose: to evaluate the factors associated with hospitalization for cardiovascular reasons in patients aged 60 years and older with heart failure.
Material and methods. The study involved 80 outpatients aged 60–89 years with heart failure. All patients underwent clinical examination, echocardiography, 6-minute walking test (6MT).
Results. Over 24,1±13,0 months of follow-up, 49 of the 80 (61,3%) patients were hospitalized (the main group). Repeated hospitalizations were available in 32 of 49 (65,3%) patients with heart failure. II FC CHF was present in 23 (47%), III FC in 24 (49%), IV FC in 2 (4%) patients. Patients who did not require hospitalization (n=31) made up the comparison group. II FC CHF was present in 28 (90%), III FC – in 3 (10%) patients, while IV FC was not established in this group. Among hospitalized patients, patients with FC III (p <0,001) were more common, among non-hospitalized patients, FC II (p <0,001). According to echocardiography, LVEF was less than 40% in 12 (25%), 40–49% in 6 (12%), 50% and more in 31 (63%) patients of the main group; less than 40% in 2 (6%), 40–49% in 3 (9%), 50% and more in 26 (85%) patients of the comparison group. Among 49 hospitalized patients, 47 (96%) had a concomitant pathology, in the comparison group – 27 (87%) patients. The risk of hospitalization for heart failure is higher in men (RR 3,28; 95% CI 1,08–9,86; p=0,035), with a 6MT distance of 258 m or less (RR 2,98; 95% CI 1,2–7,6; p=0,022), LVEF 39% and lower (RR 0,9; 95% CI 0,88–0,98; p=0,007). Hospitalizations for cardiovascular reasons were closely associated with high mortality of patients (RR 7,7; 95% CI 1,6–36,3; p=0,010).
Conclusion. Male gender, a distance of 258 meters or less in 6MT, and low LVEF were factors associated with a high risk of hospitalization. The data confirmed that 65,3% of older outpatients with CHF are re-hospitalized in clinics, and hospitalizations for cardiovascular reasons are closely associated with high mortality of patients.
Keywords: patient, hospitalizations, left ventricular ejection fraction, older age, chronic heart failure, mortality
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About the Autors

Vera N. Larina, MD, associate professor, head of the Department of polyclinic therapy, medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str. Tel.: + (910) 473-35-66. E-mail: larinav@mail.ru. ORCID: 0000-0001-7825-5597
Dmitry G. Karpenko, PhD, assistant of the Department of polyclinic therapy, medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninov Str.
Marina P. Mikhailusova, PhD, associate professor of the Department of polyclinic therapy, medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow,
1 Ostrovityaninov Str.


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