{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:19:11Z","timestamp":1788430751776,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background: Heart failure (HF) is the leading cause of hospitalisation in older adults, with incidence increasing markedly with age. However, long-term outcome data in patients aged \u226585 years remain limited. We evaluated survival and predictors of mortality in this very elderly HF population enrolled in a structured outpatient programme. Methods: A retrospective observational study was conducted, including patients aged \u226585 years assessed at a Comprehensive HF Management Unit between 2012\u20132023. Demographic characteristics, comorbidities, functional (Barthel) and cognitive (Pfeifer) status, laboratory parameters, hospitalisations, and survival status were collected. Long-term survival was estimated using the Kaplan\u2013Meier method, and predictors of mortality were analysed using Cox regression models. Results: A total of 514 patients were included (mean age 88.4 \u00b1 3 years, 46.1% male); 340 (66.1%) died during follow-up. Survival was 77% at 1 year, 50% at 2.5 years, and 25% at 5 years. Mortality was associated with diabetes (p = 0.038), advanced chronic kidney disease (p = 0.008), dementia (p &lt; 0.001), neoplasia (p = 0.007), ischaemic heart disease (p &lt; 0.001), history of HF (p = 0.043), NYHA III\u2013IV (p &lt; 0.001) and elevated NT-proBNP (p &lt; 0.001). Worse functional and cognitive status, higher comorbidity according to the Charlson Comorbidity Index and readmission at one year (all p &lt; 0.001) were also related to mortality. In the first multivariable model, worse cognitive and functional status, a higher Charlson comorbidity index, NYHA class III\u2013IV, and high NT-proBNP were independent predictors of mortality. When 1-year HF readmission was added to the model, the Charlson index (HR:1.10; 95%CI 1.01\u20131.19), high NT-proBNP (HR:1.76; 95%CI 1.30\u20132.38) and HF readmissions within 1 year (HR:2.68; 95%CI 1.72\u20134.16) remained independently associated with mortality. Conclusions: In patients aged \u226585 years with HF, survival was poor, with only half alive at 2.5 years and 25% at 5 years. Comorbidity burden, high natriuretic peptides, and early readmission independently predicted mortality, underscoring the importance of comprehensive assessment in this population.<\/jats:p>","DOI":"10.3390\/geriatrics11050119","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:20:43Z","timestamp":1788427243000},"page":"119","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Survival of Very Elderly Patients with Heart Failure Managed in a Comprehensive Heart Failure Management Unit"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6075-4945","authenticated-orcid":false,"given":"Sonia","family":"Gonz\u00e1lez-Sosa","sequence":"first","affiliation":[{"name":"Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"},{"name":"Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Alba","family":"Rodr\u00edguez-Quintana","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Pablo","family":"Santana-Vega","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Jose A.","family":"Rodr\u00edguez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Jos\u00e9 M.","family":"Garc\u00eda-Vallejo","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"},{"name":"Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Jorge","family":"Arencibia-Borrego","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-3880","authenticated-orcid":false,"given":"Alicia","family":"Conde-Martel","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, 35010 Las Palmas de Gran Canaria, Spain"},{"name":"Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: A comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2022","journal-title":"Cardiovasc. 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