SURVIVAL OF ELDERLY MEN WITH CONGESTIVE-HEART-FAILURE

Congestive heart failure (CHF) is the most common discharge diagnosis for elderly patients. The survival of elderly (age greater-than-or-equal-to 75 years) patients with CHF has not recently been reported, especially with reference to left ventricular ejection fraction (LVEF). A patient database was searched for the diagnosis of CHF and then screened for age greater-than-or-equal-to 75, Framingham Criteria for CHF and an LVEF evaluation. Ninety-four men fitted all criteria, including a minimum potential follow-up of 3 years. Life-table analysis was employed to compare their survival experience to an expected survival based on a sex- and age-equivalent subset of the 1980 Census data. Causes of death were determined from autopsy, medical records or death certificates. Mean age at onset of CHF was 82.5. Forty-three per cent had an LVEF greater-than-or-equal-to 0.45. There was no difference in the prevalence of potential aetiologies between those with LVEF greater-than-or-equal-to 0.45 versus LVEF < 0.45. Life-table analysis revealed that CHF patients had a worse survival than controls for the first 5 years after diagnosis, attributable primarily to a high first-year mortality (28%) for the CHF group. There was no difference in survival between the LVEF greater-than-or-equal-to 0.45 and LVEF < 0.45 groups.