Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan
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 adm...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Fujita Medical Society
2023-05-01
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| Series: | Fujita Medical Journal |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/fmj/9/2/9_2021-027/_pdf/-char/en |
| _version_ | 1797831781888557056 |
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| author | Masakazu Kobayashi Mutsuharu Hayashi Ryo Yamada Tomoya Ishiguro Wakaya Fujiwara Hideki Ishii Hiroyuki Naruse Eiichi Watanabe Yukio Ozaki Hideo Izawa |
| author_facet | Masakazu Kobayashi Mutsuharu Hayashi Ryo Yamada Tomoya Ishiguro Wakaya Fujiwara Hideki Ishii Hiroyuki Naruse Eiichi Watanabe Yukio Ozaki Hideo Izawa |
| author_sort | Masakazu Kobayashi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T13:57:13Z |
| format | Article |
| id | doaj.art-dc131df1a43e49889254579d2f53302d |
| institution | Directory Open Access Journal |
| issn | 2189-7247 2189-7255 |
| language | English |
| last_indexed | 2024-04-09T13:57:13Z |
| publishDate | 2023-05-01 |
| publisher | Fujita Medical Society |
| record_format | Article |
| series | Fujita Medical Journal |
| spelling | doaj.art-dc131df1a43e49889254579d2f53302d2023-05-08T02:50:28ZengFujita Medical SocietyFujita Medical Journal2189-72472189-72552023-05-01928083https://doi.org/10.20407/fmj.2021-027Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptanMasakazu Kobayashi0Mutsuharu Hayashi1Ryo Yamada2Tomoya Ishiguro3Wakaya Fujiwara4Hideki Ishii5Hiroyuki Naruse6Eiichi Watanabe7Yukio Ozaki8Hideo Izawa9Department of Medicine, Division of Cardiology, Fujita Health University Okazaki Medical CenterDepartment of Cardiology, Fujita Health University, School of MedicineDepartment of Cardiology, Fujita Health University Bantane HospitalDepartment of Cardiology, Fujita Health University Bantane HospitalDepartment of Cardiology, Fujita Health University Bantane HospitalDepartment of Cardiology, Fujita Health University Bantane HospitalDepartment of Cardiology, Fujita Health University, School of MedicineDepartment of Cardiology, Fujita Health University Bantane HospitalDepartment of Medicine, Division of Cardiology, Fujita Health University Okazaki Medical CenterDepartment of Cardiology, Fujita Health University, School of MedicineObjectives: 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.https://www.jstage.jst.go.jp/article/fmj/9/2/9_2021-027/_pdf/-char/enheart failureelderlytolvaptanearly initiation |
| spellingShingle | Masakazu Kobayashi Mutsuharu Hayashi Ryo Yamada Tomoya Ishiguro Wakaya Fujiwara Hideki Ishii Hiroyuki Naruse Eiichi Watanabe Yukio Ozaki Hideo Izawa Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan Fujita Medical Journal heart failure elderly tolvaptan early initiation |
| title | Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan |
| title_full | Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan |
| title_fullStr | Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan |
| title_full_unstemmed | Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan |
| title_short | Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan |
| title_sort | predictors of in hospital mortality in elderly patients with heart failure treated with tolvaptan |
| topic | heart failure elderly tolvaptan early initiation |
| url | https://www.jstage.jst.go.jp/article/fmj/9/2/9_2021-027/_pdf/-char/en |
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