Objective To investigate the predictive value of QRS duration on electrocardiogram combined with serum levels of interleukin (IL)-11 and soluble urokinase type plasminogen activator receptor (suPAR) in the prognosis of elderly patients with chronic heart failure (CHF). Methods A total of 236 elderly CHF patients diagnosed and treated in our department of cardiovascular diseases from January to December 2020 were recruited in this study. According to the occurrence of major adverse cardiovascular events (MACE) within 12 months of follow-up, they were divided into MACE group (n=76) and non-MACE group (n=160). The general data, QRS duration, and serum IL-11 and suPAR levels were compared between the 2 groups. SPSS 22.0 was used for statistical analysis. The predictive values of QRS duration and serum IL-11 and suPAR levels on the prognosis of elderly CHF patients were analyzed by receiver operating characteristic (ROC) curve. Kaplan-Meier curve was used to analyze the prognosis of the patients with different QRS duration and serum IL-11 and suPAR levels. Multivariate logistic regression analysis was adopted to analyze the prognostic factors of the patients. Results Compared with non-MACE group, the MACE group had significantly longer QRS duration [(126.74±9.63) vs (110.29 ± 9.47) ms] and higher levels of IL-11 [(64.05±14.49) vs (46.26±11.86) pg/ml] and suPAR [(3.64±0.99) vs (2.32±0.85) ng/ml] (P<0.01). ROC curve analysis showed that the area under the curve of QRS duration, IL-11 and suPAR to predict MACE in elderly CHF patients was 0.886,0.838 and 0.842, respectively, and the best cut-off value was 121.07 ms, 52.24 pg/ml and 2.88 ng/ml, respectively. The area under the curve of the combination of 3 indicators was 0.968, the sensitivity was 94.74%, and the specificity was 91.87%. Kaplan-Meier survival analysis showed that there were significant differences in the incidence of MACE among the elderly CHF patients with different QRS duration and IL-11 and suPAR levels (P<0.001). Logistic regression analysis indicated that left ventricular ejection fraction (OR=0.784,95%CI 0.684-0.898), cardiac function classification of New York Heart Association (OR=2.561, 95%CI 1.044-6.284), QRS duration (OR=1.195,95%CI 1.105-1.292), IL-11 (OR=1.115,95%CI 1.059-1.174) and suPAR (OR=4.316,95%CI 2.012-9.260) were independent influencing factors for MACE in elderly patients with CHF. Conclusion QRS duration and serum IL-11 and suPAR levels are independent risk factors for MACE in elderly patients with CHF. Combined detection of these 3 indicators has higher predictive value for the prognosis of elderly patients with CHF.