Abstract 16217: Influence of Older Age on Adverse Outcomes in Heart Failure
Background Reasons for worse outcomes among older heart failure (HF) patients are unclear. We evaluated the contributions of non-modifiable and modifiable factors in explaining variations in adverse outcomes across the spectrum of age in HF.
Methods We identified all adult Kaiser Permanente Northern California members with incident HF between 2006-2008. Left ventricular systolic function (LVSF) and time-updated comorbidities, medications, procedures, lab values (hemoglobin, eGFR, sodium, potassium); HF admissions and deaths were identified from health plan databases and state death files through 8/2010. We examined the influence of older age using a series of extended Cox regression models, sequentially adjusting for non-modifiable (LVSF, sociodemographics, comorbidities, labs) and modifiable (drugs, revascularization, HF management program) factors to determine potential explanatory factors.
Results Among 12,437 adults with incident HF, 2,329 were aged ≥85 years. Compared with age 65-74 years, ages 75-84 and ≥85 years were associated with increased risk for death, even after adjustment for non-modifiable risk factors. Adjustment for therapies during follow-up minimally changed these associations. Compared with age 65-74 years, age ≥85 years was associated with increased risk, even after adjustment for non-modifiable risk factors. Adjustment for selected therapies during follow-up did not significant change these associations.
Conclusions Older age was associated with higher mortality and more frequent HF hospitalizations; these excess risks were not fully explained by differences in LVSF, comorbidities and HF therapies.
- © 2011 by American Heart Association, Inc.