Abstract 15397: The Impact of Age on Ten Year Survival in a Large Contemporary Outpatient Cohort of Patients with Chronic Heart Failure
Heart failure (HF) can occur at any stage of life but is generally considered to be predominantly a disease of the elderly. Currently, it has been referred to as an epidemic as hospitalizations and re-hospitalizations are increasing and this may be associated with an ageing population. To address this challenge, many initiatives have been suggested and most national and international HF guidelines recommend multidisciplinary care of HF outpatients through specialized HF clinics. The Canadian Heart Failure Network (CHFN) was founded in 1999 and currently there are 27 clinics who share a common, longitudinal, electronic database specific for outpatient HF. We describe the impact of advancing age in this large contemporary cohort of HF outpatients. 18,885 HF outpatients were referred to the CHFN clinics from 1999 to 2011. Patients were treated based on national and international guidelines. Each clinic provided care and interventions according to available resources. The number of necessary clinic visits was determined by each clinic based on physician and nurse assessments. At time of first assessment, mean age was 64.8±14.3 (sd), 69% were male, and 89% were Caucasian. Etiology of HF was ischemic in 53% and baseline LVEF was 32.9±15.1% (sd). The number of cardiovascular comorbidities were distributed as 0/1, 31%; 2-5 60%; >5 9%. The number of non-cardiovascular co-morbidities were distributed as zero, 51%; 1, 31%; 2, 13 %; 3 or more, 5%. Kaplan Meier curves were constructed over a 10 yr time period based on the CHFN database. We chose age cut points of <50, 51-65, and >65yrs. KM survival curves by age at first clinic visit As expected, increasing age had a substantial impact on survival. However, this analysis of prospectively collected data from multiple HF centres provides an accurate estimate of survival in a large contemporaneous cohort of HF outpatients that can inform discussion of prognosis with patients and inform sample size calculations for randomized clinical trials.
- © 2012 by American Heart Association, Inc.