Document Detail


Risk factors for hospital admission among older persons with newly diagnosed heart failure: findings from the Cardiovascular Health Study.
MedLine Citation:
PMID:  23391194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to identify risk factors for the occurrence of all-cause hospital admissions among older persons after heart failure diagnosis, and to determine whether geriatric conditions would emerge as independent risk factors for admission when evaluated in the context of other relevant clinical data.
BACKGROUND: Efforts to reduce costs in heart failure have focused on hospital utilization, yet few studies have examined how geriatric conditions affect the long-term risk for hospital admission after heart failure diagnosis. With the aging of the population with heart failure, geriatric conditions such as slow gait and muscle weakness are becoming increasingly common.
METHODS: The study population included participants with a new diagnosis of heart failure in the Cardiovascular Health Study, a longitudinal study of community-living older persons. Data were collected through annual examinations and medical-record reviews. Geriatric conditions assessed were slow gait, muscle weakness (defined as weak grip), cognitive impairment, and depressive symptoms. Anderson-Gill regression modeling was used to determine the predictors of hospital admission after heart failure diagnosis.
RESULTS: Of the 758 participants with a new diagnosis of heart failure, the mean rate of hospital admission was 7.9 per 10 person-years (95% CI: 7.4 to 8.4). Independent risk factors for hospital admission included diabetes mellitus (HR: 1.36; 95% CI: 1.13 to 1.64), New York Heart Association functional class III or IV (HR: 1.32; 95% CI: 1.11 to 1.57), chronic kidney disease (HR: 1.32; 95% CI: 1.14 to 1.53), slow gait (HR: 1.28; 95% CI: 1.06 to 1.55), depressed ejection fraction (HR: 1.25; 95% CI: 1.04 to 1.51), depression (HR: 1.23; 95% CI: 1.05 to 1.45), and muscle weakness (HR: 1.19; 95% CI: 1.00 to 1.42).
CONCLUSIONS: Geriatric conditions are important, and potentially modifiable, risk factors for hospital admission in heart failure that should be routinely assessed at the time of heart failure diagnosis.
Authors:
Sarwat I Chaudhry; Gail McAvay; Shu Chen; Heather Whitson; Anne B Newman; Harlan M Krumholz; Thomas M Gill
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  61     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-08     Completed Date:  2013-04-26     Revised Date:  2014-02-13    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-42     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Comorbidity
Effect Modifier, Epidemiologic
Female
Geriatric Assessment* / methods,  statistics & numerical data
Health Surveys
Heart Failure* / diagnosis,  epidemiology,  psychology,  therapy
Hospitalization / statistics & numerical data*
Humans
Longitudinal Studies
Male
Mental Competency
Risk Assessment / methods*
Risk Factors
Severity of Illness Index
Stroke Volume
Time-to-Treatment / statistics & numerical data*
United States / epidemiology
Grant Support
ID/Acronym/Agency:
1U01HL105270-03/HL/NHLBI NIH HHS; 268201200036C//PHS HHS; AG-023629/AG/NIA NIH HHS; AG-027058/AG/NIA NIH HHS; AG-15928/AG/NIA NIH HHS; AG-20098/AG/NIA NIH HHS; HL080295/HL/NHLBI NIH HHS; K23 AG030986/AG/NIA NIH HHS; K23AG030986/AG/NIA NIH HHS; K24 AG021507/AG/NIA NIH HHS; K24AG021507/AG/NIA NIH HHS; N01 HC-15103/HC/NHLBI NIH HHS; N01 HC-55222/HC/NHLBI NIH HHS; N01-HC-35129/HC/NHLBI NIH HHS; N01-HC-45133/HC/NHLBI NIH HHS; N01-HC-75150/HC/NHLBI NIH HHS; N01-HC-85079/HC/NHLBI NIH HHS; N01-HC-85080/HC/NHLBI NIH HHS; N01-HC-85081/HC/NHLBI NIH HHS; N01-HC-85082/HC/NHLBI NIH HHS; N01-HC-85083/HC/NHLBI NIH HHS; N01-HC-85084/HC/NHLBI NIH HHS; N01-HC-85085/HC/NHLBI NIH HHS; N01-HC-85086/HC/NHLBI NIH HHS; N01-HC-85239/HC/NHLBI NIH HHS; P30 AG021342/AG/NIA NIH HHS; P30AG21342/AG/NIA NIH HHS; R01 AG023629/AG/NIA NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2013 Feb 12;61(6):643-4   [PMID:  23391195 ]

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