Clinical features, treatment practices, and hospital and long-term outcomes of older patients hospitalized with decompensated heart failure: The Worcester Heart Failure Study
Authors
Saczynski, Jane S.Darling, Chad E.
Spencer, Frederick A.
Lessard, Darleen M.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Department of Emergency MedicineDepartment of Medicine, Division of Geriatric Medicine
Department of Medicine, Division of Cardiovascular Medicine
Document Type
Journal ArticlePublication Date
2009-08-18Keywords
Acute DiseaseAge Factors
Aged
Aged, 80 and over
Body Mass Index
Cardiovascular Agents
Comorbidity
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Failure
Hospital Mortality
*Hospitalization
Humans
Life Style
Male
Massachusetts
Multivariate Analysis
Odds Ratio
Prognosis
Retrospective Studies
Survival Rate
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
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 > or =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.Source
J Am Geriatr Soc. 2009 Sep;57(9):1587-94. Epub 2009 Aug 13. Link to article on publisher's siteDOI
10.1111/j.1532-5415.2009.02407.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/47213PubMed ID
19682131Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/j.1532-5415.2009.02407.x