Sex-related bedside clinical variables associated with survival of older inpatients with heart failure

Background: Little is known about sex-related differences in factors affecting prognosis of heart failure (HF). We prospectively investigated the relationship between bedside clinical variables and survival of older females vs. males with HE Methods: Included were consecutive unselected inpatients, age greater than or equal to 60 years, admitted for various acute conditions. HF was chronic and of diverse etiologies. Followup extended up to 5 years. All-cause mortality was registered and statistically analyzed for association with in-hospital clinical variables. Results: Included were 162 females and 200 males. Survival rates were 52.4% and 59%, respectively, (P = 0. 1). Advanced age and renal dysfunction (RD) were associated with low survival in both sexes (P < 0.03 and 0.02, P < 0.001 and 0.01, respectively). An association with low survival was found with respect to; admission for pulmonary edema (P < 0.02), using furosemide greater than or equal to 80 mg/day (P < 0.005) and severe HF [NYHA class III-IV (P < 0.01)] in females, as well as for hypokalemia (P < 0.03) and hypocalcemia (P < 0.03) in males. On multivariate analysis RD (P < 0.001), increasing age (P = 0.008) and furosemide dosage greater than or equal to 80 mg (P = 0.02) were most significantly associated with low survival in females, while RD only was significantly associated with low survival in males (P = 0.03). Conclusions: Several clinical variables, which affect prognosis in older HF patients are sex-related and probably carry practical significance. (C) 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.