Acute Decompensated Heart Failure in the Elderly: An Observational Study in a Regional Victorian Hospital.

ABSTRACT

Objective This study aimed to evaluate the frequency, triggers, clinical management, and outcomes of acute decompensated heart failure (ADHF) episodes in the elderly population of a regional Victorian town, along with analysing long-term outcomes, including rehospitalization rates, functional status, and mortality. Methods In this single-centre retrospective study, approved by the Research Governance Unit of Goulburn Valley Health, we analysed data from patients over 65 years of age discharged with a primary diagnosis of heart failure (HF) between July 2022 and June 2023. The study included 174 episodes from 148 patients, examining demographic and clinical profiles, investigations, outcome measures, and hospital admission risk program (HARP) involvement. Results The study highlighted a high prevalence of heart failure with preserved ejection fraction (HFpEF), especially in patients over 85 years. No significant association between sex and ejection fraction categories was observed. The average length of stay was 5.9 days, with longer stays noted for females. Non-invasive ventilation emerged as a significant predictor of extended hospitalization. A 30-day readmission rate of 6.67% was noted, lower than some existing studies. Conclusion The findings underscore the complexity of ADHF management in the elderly, suggesting the need for region-specific, gender-focused strategies and indicating the potential benefits of enhanced HARP program engagement. These insights contribute to a nuanced understanding of HF management in elderly populations in regional settings.