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Which factors are associated with length of stay in older patients with acute decompensated heart failure with preserved ejection fraction?: AURORA study
Author(s) -
Nishino Masami,
Matsuhiro Yutaka,
Nakamura Hitoshi,
Yasumoto Koji,
Yasumura Keisuke,
Tanaka Akihiro,
MatsunagaLee Yasuharu,
Nakamura Daisuke,
Yano Masamichi,
Yamato Masaki,
Egami Yasuyuki,
Shutta Ryu,
Tanouchi Jun
Publication year - 2019
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13770
Subject(s) - medicine , hypoalbuminemia , acute decompensated heart failure , heart failure , ejection fraction , heart failure with preserved ejection fraction , cardiology , atrial fibrillation , blood pressure , dyslipidemia , diabetes mellitus , obesity , endocrinology
Aim In heart failure with preserved ejection fraction (HFpEF), it is unclear which factors on admission are correlated with long stays. In contrast, acute decompensated heart failure (ADHF) in older patients is associated with a high risk of a long stay. To manage older ADHF patients with HFpEF, it is important to reveal the risk factors for a long stay on admission. Methods We enrolled consecutive older patients (aged >75 years) with HFpEF (ejection fraction ≥50%) who were admitted to control ADHF from May 2014 to April 2016 using the acute heart failure registry in Osaka Rosai Hospital. We compared various factors, including age; sex; body mass index; heart rate; systolic blood pressure (SBP); atrial fibrillation; atherosclerotic risk factors, including dyslipidemia, diabetes mellitus, hypertension, smoking and chronic kidney disease; laboratory data, including brain natriuretic peptide and albumin; and medications, including loop diuretics, on pre‐admission between short‐stay (<14 days) and long‐stay groups. Results The long‐stay group consisted of 122 patients (59.5%). Multivariate analysis showed that male sex, SBP and albumin were independent predictors for long stays. According to the classification and regression tree and receiving operating characteristic curve analysis, all three factors on admission, including male sex, relatively low SBP (<155 mmHg) and hypoalbuminemia (<3.4 g/dL) could well predict the patients that would require long stays (area under curve 0.738). Conclusions Among older ADHF patients with HFpEF, male patients with relatively low SBP and hypoalbuminemia on admission should initially undergo more intensive management to reduce the length of stay. Geriatr Gerontol Int 2019; 19: 1084–1087 .