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Clinical Features, Treatment Practices, and Hospital and Long‐Term Outcomes of Older Patients Hospitalized with Decompensated Heart Failure: The Worcester Heart Failure Study
Author(s) -
Saczynski Jane S.,
Darling Chad E.,
Spencer Frederick A.,
Lessard Darleen,
Gore Joel M.,
Goldberg Robert J.
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02407.x
Subject(s) - medicine , heart failure , acute decompensated heart failure , intensive care medicine , term (time) , pediatrics , physics , quantum mechanics
OBJECTIVES: To examine age‐specific differences in clinical presentation, receipt of therapeutic practices and lifestyle recommendations, and hospital and long‐term survival in patients hospitalized for acute heart failure HF. DESIGN: Population‐based study. SETTING: The Worcester Heart Failure Study, a population‐based study of residents of the a large Central New England metropolitan area hospitalized for decompensated HF at 11 greater‐Worcester medical centers. PARTICIPANTS: Four thousand five hundred thirty‐four patients hospitalized for decompensated HF during 1995 and 2000. MEASUREMENTS: Medical records were reviewed for demographic, clinical, and treatment characteristics and hospital survival status. Long‐term follow‐up of discharged hospital patients was conducted through 2005. Patients were compared according to four age groups (<65, 65–74, 75–84, and ≥85). RESULTS: Mean age was 76; 24.0% were aged 85 and older. Patients aged 75 and older were more likely to be female and to have multiple comorbidities, a lower body mass index at the time of hospitalization, and higher ejection fraction findings. Older patients were significantly more likely to receive symptom‐modifying medications and less likely to receive disease‐modifying medications than younger patients. Older age was directly associated with higher in‐hospital, 30‐day, and 1‐year death rates in crude and multivariable‐adjusted analyses. CONCLUSION: The results of this community‐wide study suggest that clinical, treatment, and prognostic factors differ according to age in patients hospitalized for decompensated HF. These high‐risk patients warrant special attention in future studies to improve their management and long‐term survival.