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Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan

Authors :
Masakazu Kobayashi
Mutsuharu Hayashi
Ryo Yamada
Tomoya Ishiguro
Wakaya Fujiwara
Hideki Ishii
Hiroyuki Naruse
Eiichi Watanabe
Yukio Ozaki
Hideo Izawa
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.

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