Clinical factors for mortality in very elderly patients with atrial fibrillation
Background and aim: There is limited information available about the cause of death of very elderly patients with atrial fibrillation aged ≥ 85 years. The aim of this study was to clarify the cause of death and clinical risk factors for very elderly patients with AF ≥ 85 years. Method; A total of 1,196 patients with AF registered in the KIBIDAN-GO registry at Kawasaki Medical School between 2002 and 2017, were retrospectively studied. We divided the patients into 2 groups (age < 85 years and age ≥ 85 years old) and compared the cause of death and clinical risk factors for death between the 2 groups. Results: During the follow-up period (median follow-up period was 4360 days), 239 patients (20%) died. The main cause of death was non-CV disease in both groups. The multivariate Cox regression analysis showed that body mass index (BMI) [hazard ratio (HR); 0.55, 95% confidence interval (CI) (0.33-0.87), p = 0.01], hemoglobin (HR 0.93, 95% CI (0.87-0.98), p = 0.02), and anticoagulants [HR 1.4, 95% CI (1.04-1.63), p = 0.04] were associated with all-cause death in patients aged < 85 years old. On the other hand, BMI [HR 0.55, CI 95% (0.55-0.63), p = 0.01] and chronic kidney disease (CKD) (HR 1.87, 95% CI (1.10-1.80), p = 0.04) were associated with all-cause death in patients aged ≥ 85 years. Conclusions: In very elderly patients with AF, the main cause of death was non-CV disease, and CKD and BMI were significantly associated with all-cause death.
