Purpose: To evaluate the in-hospital (IH) outcome and the short-term follow-up of predominantly elderly patients presenting to an emergency room (ER) with congestive heart failure (CHF).
Methods: In an 11 month period, 57 patients presenting to the ER with CHF were included. Mean age was 69 +/- 15 years (27 to 94) and 39 (68.4%) were male. CHF diagnosis was based on the Boston criteria. We evaluated IH outcome and prognosis in a mean follow-up of 5.7 +/- 2.7 months (1 to 12). In addition, some mortality predictors and mechanisms of death according on the ACME system were identified.
Results: Eight patients (14%) died in the IH period. Modes of death were circulatory failure (CF) in 7, and peri-operative (PO) in one (aortic valve replacement). During follow-up 9 deaths occurred. Five were due to CF, 2 were sudden and 2 were PO (mitral valve replacement and ventriculectomy). Six-months and 1-year survival rates of the patients who were discharged were 82% and 66%, respectively. Sodium lower than 135 mEq/l (p = 0.004) and female gender (p = 0.038) were independent predictors of mortality.
Conclusion: Elderly patients with CHF admitted to the ER have high in-hospital and short-term follow up mortalities. The majority die from CF due to worsening heart failure.