Differences, If Any, in Prognostic Indicators of Heart Failure: Comparison between Octogenarians and Nonagenarians

Super-elderly with heart failure needing hospitalization have a high mortality risk, but factors contributing to prognosis are unknown. Previously, activities of daily living (ADLs), nutritional status and mastication/swallowing ability upon admission, and not cardiovascular factors were indicated as contributors to this risk. It is unclear whether this tendency is similar between octogenarians and nonagenarians. Our study aims to investigate the point, comparing between octo- and nonagenarians. Patients and Methods: A retrospective analysis was performed in super-elderly (aged >80 years) hospitalized with congestive heart failure, who were diagnosed based on the Diagnosis Procedure Combination coding system. Clinical outcomes were assessed at the time of hospital discharge. Results: Over 18 months, we registered 146 patients with mean age being 89.2 years. We studied 82 octogenarians and 64 nonagenarians. Clinical outcomes were divided into three subgroups: those who died during hospitalization (n = 26), 27; those who needed additional nursing care (n = 15), 13; and those able to walk at discharge (n = 41), 24, respectively. Factors contributing to the outcomes were ADL and albumin values, presence of atrial fibrillation, and mastication/swallowing ability upon admission. No significant difference was observed between octo- and nonagenarians with respect to composition and tendency. Conclusion: In nonagenarians, index of living ability seems to be a more important prognostic indicator than cardiovascular factors as well as octogenarians.