Abstract 12668: Geriatric Patients Admitted for Heart Failure are Less Likely to Have Follow-up Appointments Scheduled Prior to Discharge
Introduction: Post-discharge medical follow-up among geriatric patients admitted with heart failure (HF) is especially important given high rates of multimorbidity and polypharmacy.
Hypothesis: Patients admitted with HF aged ≥65 years will have a high rate of follow-up appointments (FUA) scheduled upon discharge from the hospital.
Methods: We studied patients discharged home from a medicine service with principal diagnosis of HF at an academic hospital in NYC during 2013-2014. Patients discharged to hospice were excluded. We collected demographics, hospitalization characteristics, clinical indices, and FUA data by chart review.
Results:. 796 unique patients were hospitalized with HF, among whom 443 (56%) had an FUA scheduled prior to discharge. Patients who did not have an FUA were older, more commonly white, and less likely to have Medicaid (Table). They had higher LVEF and higher rates of HFpEF (LVEF≥50%) compared to those with an FUA. Patients with and without an FUA were similar with respect to rates of coronary artery disease (CAD), RV dysfunction, valvular disease, atrial fibrillation/flutter (AF), and ventricular tachycardia. Patients also had similar rates of non-cardiac comorbidities irrespective of having an FUA, with the exception of COPD, which was more common among those with an FUA. Despite increased rates of CAD, AF, COPD, gastrointestinal bleeding, cancer, and cerebrovascular accidents, patients aged ≥65 years were less likely to have an FUA (52% vs. 65%, p=0.001). In multivariate analysis controlling for race, insurance, COPD, and HFpEF, age ≥65 remained independently associated with not having a scheduled FUA upon hospital discharge (OR 1.45, [1.02 to 2.05], p=0.03).
Conclusions: Despite higher burden of both cardiac and non-cardiac disease, patients aged ≥65 years admitted with HF were less likely to have a follow-up appointment upon discharge. This highlights an important disparity in care of the geriatric population that must be addressed.
Author Disclosures: P. Goyal: None. A.N. Beecy: None. M. Sterling: None. J.T. Ruffino: None. S. Mehta: None. M.S. Lachs: None. E.C. Jones: None. E.M. Horn: None.
- © 2015 by American Heart Association, Inc.