Predictors of cardiovascular outcome and rehospitalization in elderly patients with heart failure

Eur J Clin Invest. 2019 Feb;49(2):e13044. doi: 10.1111/eci.13044. Epub 2018 Nov 16.

Abstract

Background: Heart failure (HF) is a major public health problem and represents the only cardiac disease continuing to increase in prevalence, in particular among elderly patients. The frequent rehospitalizations have a negative impact on quality of life of patients with HF, constituting a substantial cost for patients and the health system. The aim of this review was to look into biochemical, echocardiographic and socioeconomical parameters as predictors of clinical outcomes and rehospitalizations.

Methods: This narrative review is based on the material searched for and obtained via PubMed from January 2000 up to March 2018. The search terms we used were as follows: "elderly, heart failure, cardiovascular" in combination with "biomarker, echocardiography and hospitalization."

Results: This review analyses the potential predictive role of biochemical and echocardiographic and socioeconomical parameters on clinical outcomes (particularly cardiovascular) and hospital readmissions in patients with chronic HF. We focused on risk stratification of elderly patients with HF, who constitute a category of frail subjects at higher risk for readmission to hospital.

Conclusions: In elderly subjects with chronic HF, the risk stratification could benefit of a multiparametric approach combining biochemical, echocardiographic, demographic and socioeconomical parameters, thus ensuring a better quality of life and at the same time a better allocation of financial resources.

Keywords: elderly patients; heart failure; predictors of rehospitalization; readmission.

Publication types

  • Review

MeSH terms

  • Aged
  • Anemia / blood
  • Anemia / etiology
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism
  • Cardio-Renal Syndrome / blood
  • Cardio-Renal Syndrome / etiology
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Chronic Disease
  • Echocardiography
  • Heart Failure / blood
  • Heart Failure / diagnostic imaging
  • Heart Failure / therapy*
  • Humans
  • Hyperuricemia / blood
  • Hyperuricemia / etiology
  • Hyponatremia / blood
  • Hyponatremia / etiology
  • Natriuretic Peptides / metabolism
  • Parathyroid Hormone / metabolism
  • Patient Readmission / statistics & numerical data*
  • Risk Factors
  • Stroke Volume / physiology
  • Troponin / metabolism
  • Vitamin D / metabolism

Substances

  • Biomarkers
  • Natriuretic Peptides
  • Parathyroid Hormone
  • Troponin
  • Vitamin D
  • C-Reactive Protein