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Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan
- Source :
- Fujita Medical Journal, Vol 9, Iss 2, Pp 80-83 (2023)
- Publication Year :
- 2023
- Publisher :
- Fujita Medical Society, 2023.
-
Abstract
- Objectives: We conducted an analysis of first-time tolvaptan users (≥80 years old) to determine the factors associated with the prognosis of elderly patients with heart failure. Methods: We retrospectively analyzed 66 consecutive patients with worsening heart failure (aged ≥80 years) who were admitted to Fujita Health University Bantane Hospital from 2011 to 2016 and treated with tolvaptan. Differences between the in-hospital death and survival groups were evaluated. Multivariate logistic regression analysis was also performed to identify the risk factors for mortality. Results: Sixty-six patients were included, and 26 patients died during the index hospitalization. The patients who died had a significantly higher prevalence of ischemic heart disease; a higher heart rate; higher levels of plasma C-reactive protein, blood urea nitrogen (BUN), and creatinine; a lower serum albumin level; and a lower estimated glomerular filtration rate than surviving patients. The proportion of patients requiring early initiation of tolvaptan treatment (within 3 days of admission) was significantly higher in surviving patients. On the basis of multivariate logistic regression analysis, although a high heart rate and high BUN levels were independent factors for in-hospital prognosis, they were not significantly associated with the early use of tolvaptan (≤3 days vs. ≥4 days; odds ratio=0.39; 95% confidence interval=0.07–2.21; p=0.29). Conclusions: This study revealed that a higher heart rate and higher BUN levels were independent factors for in-hospital prognosis in elderly patients who received tolvaptan and that early tolvaptan use may not always be effective in elderly patients.
- Subjects :
- heart failure
elderly
tolvaptan
early initiation
Medicine (General)
R5-920
Subjects
Details
- Language :
- English
- ISSN :
- 21897247 and 21897255
- Volume :
- 9
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Fujita Medical Journal
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.131df1a43e49889254579d2f53302d
- Document Type :
- article
- Full Text :
- https://doi.org/10.20407/fmj.2021-027