PS1-09: Clinical Features, Treatment Practices, and Outcomes of Older Patients Hospitalized with Decompensated Heart Failure.
ABSTRACT Background: Heart failure (HF) disproportionately affects older adults and previous studies have suggested that the demographic as well as clinical profile of older patients with HF is different from that of younger patients. However, generalizable, population-based data on the clinical, treatment, and prognostic profile of older as compared to middle aged and younger patients with HF are lacking. Methods and Results: Residents of the Worcester (MA) metropolitan area hospitalized for de-compensated HF at 11 greater Worcester medical centers during 1995 and 2000 (n=4,534) were compared according to 4 age groups (<65, 65-74, 75-84, and >85 years). The mean age of patients with acute HF was 76 years and 24% were >85 years. Older patients (>75) were more likely to be female and to have higher ejection fraction findings, multiple comorbidities, and a lower body mass index. Older patients were significantly more likely to receive symptom modifying medications and less likely to receive disease modifying medications than younger patients. Advanced age was directly associated with increased in- hospital, 30-day, and 1-year death rates in both crude and adjusted analyses. Conclusions: The results of this communitywide study suggest that clinical, treatment, and prognostic factors differ by age in patients hospitalized for de-compensated HF. These high-risk patients warrant special attention in future studies in order to improve their management and long-term survival.