ObjectiveTo evaluate the clinical risk factors of heart failure following an abdominal operation in elderly patients. MethodsA total of 762 patients (≥65 years) who underwent an abdominal operation were divided into heart failure group (n=32) and control group (n=730). Their clinical data were analyzed retrospectively to evaluate the risk factors of heart failure. ResultsNineteen patients (59.3%) sufferred from heart failure at 1-3 days after abdominal operation. Compared with control group,in heart failure group,there were more patients of advanced age(53.1% vs 25.2%),more patients with history of coronary heart disease (62.5% vs 38.6%) and heart failure (25.0% vs 4.0%),more patients following emergency operation(41.4% vs 15.8%),more patients with preoperative ST segment depression (≥0.05mV)(34.4% vs 18.2%),more patients with WBC>10×109/L at 1-3 days after operation(31.3% vs 16.0%),and more patients with infusion fluid ≥2 500ml/d(21.9% vs 7.1%,P<0.05). A multivariable logistic regression analysis showed that the history of heart failure(OR=9.52),emergency operation (OR=15.723) and advanced age (OR=2.933) were independent risk factors of heart failure in elderly patients who underwent an abdominal operation. ConclusionAdvanced age,history of coronary heart disease and heart failure,emergency operation,preoperative ST segment depression,WBC>10×109/L at 1-3 days postoperatively and infusion fluid ≥2 500ml/d are more common in patients with heart failure than patients without heart failure following an abdominal operation. The history of heart failure,emergency operation and advanced age are independent risk factors of heart failure in elderly patients who underwent an abdominal operation.