Retrospective single-center study finds 33.4% mortality in hospitalized heart failure

A retrospective, hospital-based study of 1,000 patients admitted with heart failure at a major cardiovascular center in northern Iran found all-cause mortality in 334 patients, or 33.4% of the cohort. The analysis also identified older age and the HFrEF phenotype as factors independently associated with higher mortality in the adjusted statistical model. Researchers systematically extracted baseline demographic, clinical, echocardiographic and laboratory data from medical records and the hospital information system.

All-cause mortality was ascertained through linkage with the regional mortality registry, while multivariable logistic regression was used to estimate associations between baseline factors and death. The study population was divided into the HFrEF, HFmrEF and HFpEF heart-failure phenotypes for comparison. The patients had a mean age of 68.9 ± 14.7 years, and 51.8% were male.

Comorbidities were common: hypertension was recorded in 68.7% of participants, diabetes in 47.0% and ischemic heart disease in 42.9%. The findings therefore describe a hospitalized population with a substantial burden of cardiovascular and metabolic disease, rather than the full population of people living with heart failure. Mortality proportions differed significantly among the three heart-failure phenotypes.

They were 35.4% in HFrEF, 28.7% in HFmrEF and 23.6% in HFpEF, with the reported difference assessed at P = 0.035. These values are proportions observed within the hospital cohort; they are not population incidence rates and should not be treated as direct estimates of mortality risk among all people with heart failure in northern Iran. Increasing age was independently associated with higher odds of all-cause mortality in the multivariable model.

For each additional year of age, the adjusted odds ratio was 1.032, with a 95% confidence interval of 1.021–1.043 and P < 0.001. This was an adjusted observational association, not evidence that aging itself caused the higher mortality observed in the cohort. The HFrEF phenotype was also independently associated with higher mortality.

Its adjusted odds ratio was 1.917, with a 95% confidence interval of 1.128–3.256 and P = 0.016. The source abstract does not provide the full specification of the regression model, including the reference category used for this comparison. The result therefore supports an association within the analyzed hospital population without establishing a causal relationship.

Comorbid cancer showed an inverse association with mortality in the same adjusted analysis. Cancer was present in patients who had lower adjusted odds of all-cause mortality, with an adjusted odds ratio of 0.436, a 95% confidence interval of 0.201–0.948 and P = 0.036. The supplied findings do not identify the mechanism behind this association or establish that cancer reduces the risk of death from heart failure.

Overall, the study documents substantial all-cause mortality and a high burden of comorbidities among 1,000 heart-failure patients treated at one cardiovascular center in northern Iran. Its model estimates identify older age, HFrEF and comorbid cancer as variables independently associated with mortality in this specific clinical setting. The retrospective design, single-center setting and restriction to hospitalized patients limit broader generalization and comparison with community cohorts.

The authors called for longitudinal, multicenter investigations to validate the results before wider application.

Subject of Research: Mortality and clinical profiles among 1,000 hospitalized heart-failure patients in northern Iran

Article Title: Epidemiological patterns, clinical profiles and mortality outcomes of patients with heart failure: a retrospective, hospital-based, single-center study in northern Iran

Article References: Moradi, M., Charati, J. Y., Ranjbar, M., Nabati, M., & Jalalian, R. (2026). Epidemiological patterns, clinical profiles and mortality outcomes of patients with heart failure: a retrospective, hospital-based, single-center study in northern Iran. BMC Public Health. https://doi.org/10.1186/s12889-026-29636-8

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DOI: 10.1186/s12889-026-29636-8

Keywords: heart failure, HFrEF, HFmrEF, HFpEF, all-cause mortality, northern Iran, retrospective cohort, single-center study, comorbidities, multivariable regression, Epidemiological, patterns