Abstract 21045: A Prospective Population Study of the Rate and Risk of Hospitalization among Medicare-Eligible Community-Dwelling Older Adults with Incident Heart Failure
Background: In the US annually ∼670,000 patients are newly diagnosed with heart failure (HF) and ∼1 million patients are hospitalized for HF. Data from HF registries based on hospitalized HF patients suggest that 15% to 30% of all hospitalized HF patients are newly diagnosed with HF. However, there is little prospective data about the rate and risk of hospitalization among those with incident HF.
Methods: Of the 5795 Medicare-eligible community-dwelling adults ≥65 years who participated in the Cardiovascular Health Study, 5521 (95%) were free of prevalent HF at baseline, of which 1139 (21%) developed centrally-adjudicated new HF during >12 years of follow-up. Data on HF hospitalization was obtained from Medicare claims files and International Classification of Diseases, 9th Revision (ICD-9) codes were used to identify a primary discharge diagnosis of HF. Cox regression models were used to identify baseline characteristics that predicted HF hospitalization either during or after incident HF.
Results: Patients with incident HF (n=1139) had a mean age of 75 (±6) years, 49% were women, 14% African American, and 66% died during >12 years of follow-up. During this same period, 520 (46%) patients with incident HF were hospitalized due to HF. Incident HF was diagnosed during HF hospitalization in 304 (27%) patients. Of the 835 in whom incident HF was diagnosed in the outpatient setting, subsequent HF hospitalization occurred in 216 (26%). Baseline characteristics associated with HF hospitalization (either during or after incident HF) are displayed in Table 1.
Conclusion: Among community-dwelling older adults, over half of the patients with incident HF were diagnosed in the outpatient setting and were not hospitalized during >12 years of follow-up. A number of patient characteristics, comorbidities, and risk factors predicted these hospitalizations.
- © 2010 by American Heart Association, Inc.