Abstract 20952: Incidence and Predictors of Hospitalization due to Heart Failure among Medicare-Eligible Community-Dwelling Older Adults with Prevalent Heart Failure: Insights from a Prospective Population Study
Background: Heart failure (HF) is the leading cause of hospitalization for Medicare beneficiaries age ≥65 years. HF is also the leading cause of re-hospitalization for HF patients and is associated with increased mortality. Most data on HF hospitalization are derived from administrative databases, clinical trials, or hospitalized HF registries and little is known about the incidence and predictors of HF hospitalization among HF patients in the community.
Methods: Of the 5795 Medicare-eligible community-dwelling adults ≥65 years in the Cardiovascular Health Study, 274 (4.7%) had centrally-adjudicated prevalent HF at baseline. Data on hospitalization was obtained from Medicare claims data and International Classification of Diseases, Ninth Revision (ICD-9) codes were used to identify a primary discharge diagnosis of HF. We constructed a multivariable Cox regression model to identify baseline characteristics that predicted HF hospitalization.
Results: Participants had a mean age 75 (±6) years, 52% were women, and 22% were African American. Overall, 208 (76%) HF patients died from all causes, 257 (94%) had all-cause hospitalization, and 111 (41%) had a hospitalization due to HF during >12 years of follow-up. Of those with HF hospitalization, 46% had multiple hospitalizations. Rates for 1, 5 and 10 year HF hospitalization were 8%, 27%, and 38% respectively. Independent predictors of hospitalization due to HF are displayed in the Table. Other major causes for hospitalizations included acute myocardial infarction (14%), ischemic heart disease (30%), stroke (15%) and pneumonia (23%).
Conclusions: Despite a very high mortality and all-cause hospitalization and being the leading cause of hospitalization for Medicare beneficiaries, most Medicare-eligible community-dwelling older adults with HF were not hospitalized for HF. Several risk factors were identified that may help identify patients at risk for HF hospitalization for prevention efforts.
- © 2010 by American Heart Association, Inc.