Background: In the elderly the most common cause of hospitalisation and the leading cause of death is heart failure (HF).

Aim: The purpose was to determine prognostic factors in chronic HF (CHF) in octogenarians and nonagenarians.

Methods: The analysis included 197 consecutive patients over 80 years old (mean age 83.63 ± 3.01 years; 46.19% men) hospitalised in 2010–2013 due to CHF. Sixty-two parameters were investigated, such as: age, gender, New York Heart Asso­ciation functional class, body mass index, blood pressure, other comorbidities, the parameters of the 12-lead resting electro­cardiography and the echocardiography, the results of basic laboratory tests, and selected biomarkers, including N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T (hs-TnT), and high-sensitive C-reactive protein. Participants remained in a prospective follow-up for 12 months. We defined the primary endpoint as death due to cardiovascular causes and the composite endpoint, which consisted of: death due to cardiovascular causes and/or hospitalisation for exacerbation of CHF. Follow-up concerning the deaths was performed in 189 patients, composite endpoint in 168 and hospitalisation in 166. The uni- and multivariate logistic regression stepwise analysis was performed for the entire population, according to left ventricular ejection fraction (LVEF < 45% and ≥ 45%) and in the group with glomerular filtration rate (GFR) < 60 mL/min.

Results: Patients who died constituted 11.1% of the study population (21/189). In multivariate analysis four variables were independently associated with the primary endpoint: GFR (OR = 0.92), hypertension (OR = 0.19), lung diseases (OR = 9.36), and vascular diseases (OR = 6.07). In turn, in the group of patients who reached the composite endpoint (55/168; 32.7%), the only statistically significant independent variable was anaemia (OR = 4.71). In the subpopulation of patients with LVEF < 45% the prognostics for each endpoint were vascular diseases and lung diseases, and they increased the risk from 10- to 24-fold. In the subgroup of patients with LVEF ≥ 45% the independent variable associated with the composite endpoint was haemoglobin (OR = 0.61), in turn for death the prognostics were: white blood cell count, hs-TnT, and vascular diseases (respectively OR = 1.30; OR = 1.04; OR = 3.96). In the population with GFR < 60 mL/min variables with prognostic importance for the composite endpoint were red blood cell parameters: red blood cell distribution width (OR = 1.42) and anaemia (OR = 3.79), while for occurrence of death they were the same as for the entire population — vascular (OR = 5.16) and lung diseases (OR = 4.72).

Conclusions: In patients over 80 years old with CHF, comorbidities are of important prognostic value for annual prognosis. The most aggravating factor in studied subgroups was lung disease.