Abstract / Summary
Abstract Background Heart failure (HF) remains a major global public health challenge, with a rising prevalence driven by aging populations. This study aimed to describe the epidemiological patterns and clinical profiles of hospitalized HF patients in northern Iran and to identify factors independently associated with all-cause mortality within this specific clinical setting. Methods This retrospective hospital-based study included 1,000 patients hospitalized with HF at a major cardiovascular center in northern Iran. Baseline demographic, clinical, echocardiographic, and laboratory data were systematically extracted from medical records and hospital information systems. All-cause mortality was ascertained through data linkage with the regional mortality registry. Multivariable logistic regression analysis was employed to identify independent predictors of mortality. Results The study included 1,000 patients (mean age 68.9 ± 14.7 years; 51.8% male). Prevalent comorbidities included hypertension (68.7%), diabetes (47.0%), and ischemic heart disease (42.9%). All-cause mortality occurred in 334 patients (33.4%). Mortality proportion varied significantly across HF phenotypes: 35.4% in HFrEF, 28.7% in HFmrEF, and 23.6% in HFpEF ( P = 0.035). In multivariable logistic regression analysis, increasing age (aOR = 1.032, 95% CI: 1.021–1.043, P < 0.001) and HFrEF (aOR = 1.917, 95% CI: 1.128–3.256, P = 0.016) were independently associated with higher mortality; in contrast, the presence of comorbid cancer (aOR = 0.436, 95% CI: 0.201–0.948, P = 0.036) was independently associated with lower odds of mortality. Conclusion Hospitalized HF patients in our study presented with a high burden of comorbidities and substantial mortality. Increasing age, the HFrEF phenotype, and comorbid cancer were independently associated with all-cause mortality in the adjusted model. These findings underscore the critical value of early phenotypic stratification and targeted, risk-based management in this specific population, while highlighting the necessity of future longitudinal, multicenter investigations to validate these results before broader generalization.