Differential clinical characteristics and outcome predictors of acute heart failure in elderly patients Pablo Herrero-Puente a, ⁎, Francisco Javier Martín-Sánchez b , María Fernández-Fernández c , Javier Jacob d , Pere Llorens e , Òscar Miró f , A.B. Alvarez g , M.J. Pérez-Durá h , H. Alonso i , M. Garrido j and Representing the members of the ICA-SEMES group (Annex 1) 1 a Area of Emergency Medicine, Hospital Universitario Central de Asturias, Emergency Medicine Investigation Group-HUCA, Oviedo, Spain b Emergency Department and UCE, Hospital Clínico San Carlos, Madrid, Spain c Geriatrics Department, Hospital Monte Naranco, Oviedo, Spain d Emergency Department, Hospital de Bellvitge, Barcelona, Spain e Emergency Department-UCE and Home Hospitalisation, Hospital Universitario General de Alicante, Alicante, Spain f Emergency Department, Hospital Clinic, Barcelona, Emergency Medicine Investigation Group “Emergency care: processes and diseases”, IDIBAPS, Barcelona, Spain g Emergency Department, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain h Emergency Department, Hospital La Fe, Valencia, Spain i Emergency Department, Hospital Marqués de Valdecilla, Santander, Spain j Emergency Department, Hospital Virgen Macarena, Sevilla, Spain abstract article info Article history: Received 27 January 2011 Accepted 10 February 2011 Available online 12 March 2011 Keywords: Heart failure Emergency department Mortality Re-consultation Elderly Objective: We determined the clinical-epidemiological characteristics and prognostic factors of early mortality and re-consultation in an elderly population attending the hospital emergency department (HED) for acute heart failure (AHF). Patients and methods: A prospective, observational, non interventional study including all the patients with AHF attended in the Spanish's HED. Two groups were defined: elderly (≥80 years) and controls (b 80 years). Variables: demographic characteristics, comorbidity, degree of cardiac involvement, previous treatment, symptoms and signs of the AHF episode, precipitating factors, treatment in the HED and outcome. Outcome variables: mortality and re- consultation within 30 days. Results: Of the 942 patients included, 455 of whom were elderly (48.3%). In this elderly population female sex, auricular fibrillation and a history of ictus and a poor functional status predominated. The type of ventricular dysfunction was unknown in 70%. No main differences in the presentation of AHF were found between the two groups. Mortality and re-consultation to the HED within 30 days were similar in both groups. While several factors were identified to be related to mortality or re-consultation in control group, in the elderly group it was more difficult to identify patients who will die or re-consult to the HED within the following 30 days. Only respiratory insufficiency on arrival to the HED was found to predict a greater probability of death (OR 3.55; CI95% 1.39–9.11). Conclusions: AHF in elderly patients presents some differential characteristics and, most importantly, it is more difficult to identify which of these patients will die or re-consult in the short-term. © 2011 Elsevier Ireland Ltd. All rights reserved. International Journal of Cardiology 155 (2012) 81–86 ⁎ Corresponding author at: Área de Urgencias, Hospital Universitario Central de Asturias, C/Celestino Villamil s/n, 33006 Oviedo, Spain. Tel.: +34 985108020. E-mail address: pabloherrero71@hotmail.com (P. Herrero-Puente). 1 Annex 1. Members of the EAHFE group: - González Armengol JJ, González del Castillo J. Hospital Clinico San Carlos, Madrid, Spain. - Llopis F, Álvarez A, Iglesias L, Palom X. Hospital Universitario de Bellvitge, Barcelona, Spain. - Laghzoui F, Diéguez S, Carbajosa JF, Murcia J. Hospital General Universitario de Alicante, Alicante, Spain. - Pavón J, Sánchez Nayra, Casal LM, Lubillo JT, Medina J. Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain. - Pozo A, Álvaro E, Valles JM, García A. Hospital La Fe, Valencia, Spain. - González C, Martín JM, Diego F, Alario MJ, Grande S. Hospital Universitario de Salamanca, Salamanca, Spain. - Gil V, Perelló R, Escoda R. Hospital Clinic, Barcelona, Spain. - Vázquez-Álvarez J, Gil-Román JJ, Antuña-Montes L, González-Méndez A. Hospital Universitario Central de Asturias, Oviedo, Spain. - Iglesias L, Pérez G, Gómez-Ullate F, Díaz JM. Hospital Marqués de Valdecilla, Santander, Spain. 0167-5273/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2011.02.031 Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard