Abstract 12514: National Patterns of Heart Failure Hospitalizations and Mortality by Gender and Age

Abstract

Background: Prior work has demonstrated significant gender and age disparities in ischemic heart disease. However, it remains unclear if an age or gender gap exists for heart failure (HF) patients.

Methods: Using data from the 2007-2008 Healthcare Cost and Utilization Project, we constructed hierarchical regression models to examine gender differences and age-gender interactions in HF hospitalizations and in-hospital mortality, adjusting for patient comorbidities.

Results: Among 430,665 HF discharges, 51% were women; 0.3%, 27%, and 73% were age <25, 25-64, and >64 years, respectively. Men had higher hospitalization rates for HF and in-hospital mortality across virtually all ages. However, age had a greater impact on HF hospitalization rates for women. The relationship between age and HF mortality appeared U-shaped; mortality rates for age <25, 25-64, and >64 were 2.9%, 1.4%, and 3.8%, respectively. No age-gender interaction was found for in-hospital mortality for adults over 25.

Conclusions: Using a large, nationally representative administrative dataset we found age and gender disparities in HF outcomes. In general, men fared worse than women irrespective of age. Further, we found a U-shaped relationship between age and in-hospital mortality during a HF admission, such that young adults have similar mortality rates to older adults. Future prospective studies are warranted to elucidate the patient-specific and treatment characteristics that lead to improved outcomes in women and to worse outcomes in younger patients and men with heart failure.