Background: For the old old patients (pts) with congestive heart failure the use of combinations of drugs can easily lead to a sort of "evidence-based" polypragmasie and a longer length-of-stay (LOS).
Methods: We analyzed a lot of 125 pts older than 85 years (mean 87.43 +/- 2.54 years, range 85-99 years), 53.6% male, enrolled consecutively between January 2011 - December 2012, diagnosed with congestive heart failure. We have compared some features of two subgroups: survivors (S=112 pts) vs deceased (D=13 pts).
Results: The old old patients group included patients diagnosed mainly with ischemic dilated cardiomyopathy (57/45.6%), alcoholic cardiomyopathy (4/3.2%), mixed (26/20.8%), hypertensive cardiopathy (31/30.4%), in NYHA class II (61/48.8%), class III (55/44%) and class IV (9/7.2%), with length of hospitalization of 8.10+/-3.98 days and the rate of re-hospitalization 6.4% and the death rate 10.4%. Number of drugs taken was 5.53+/-1.86 in S group vs 5.85+/-1.86 in D group (p = 0.421) and the length-of-stay was 8.18+/-3.79 in S group vs 7.38+/-5.53 in D group (p = 0.06). There were significant differences between group S vs D in: NYHA class, non- smoker status, hemoglobin level (12.57+/-1.92 vs 11.20+/-1.87 g/dl, p = 0.017), blood urea nitrogen (58.38+/-28.92 vs 77.30+/-47.99 mg/dl, p = 0.04), serum uric acid (6.32+/-1.99 vs 8.91+/-4.27 mg/dl, p = 0.001), serum sodium (139.97+/-4.55 vs 136.69+/-7.12 mg/dl, p = 0.024) and BNP (524.49+/-116.87 vs 2480.75+/-951.99 pg/ml, p = 0.001).
Conclusions: The number of drugs given to old old patients has not proven to reduce the length of stay, the rate of death and re-hospitalization. Hyponatremia, anemia and increased urea and serum uric acid are associated with increased mortality of old old patients.