Impact of congestive heart failure, chronic kidney disease, and anemia on survival in the Medicare population

Charles A. Herzog, Heather A. Muster, Shuling Li, Allan J. Collins

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


Background Congestive heart failure (CHF) is a common clinical problem in the elderly, yet few studies have focused on this population. In addition, information on mortality rates conferred by chronic kidney disease (CKD) and anemia in elderly patients with CHF is lacking. Methods and results A cohort of 1,136,201 patients in the 5% Medicare database, excluding those with end-stage renal disease (ESRD), was identified for a 2-year period (1996-1997). Subgroups with CHF, CKD, and anemia were identified. The effect of each disease as an independent predictor of mortality was examined in a comorbidity-adjusted Cox model, with patients followed for 2 years and censored for death or ESRD. In the study population, 61% were women; 89% were white and 7% were black. Mean ±SD age was 76.5 ± 6.9 years. The annual mortality rate for patients with no CHF, CKD, or anemia was 4%. Anemia was associated with an annual mortality of 8%, which was the same as CKD (8%). The annual mortality for CHF was 13%. The highest annual mortality was found in patients with all 3 comorbid conditions; mortality in these patients was 23%. Conclusions Elderly CHF patients are at high risk of death; this risk is magnified in the presence of CKD and anemia.

Original languageEnglish (US)
Pages (from-to)467-472
Number of pages6
JournalJournal of cardiac failure
Issue number6
StatePublished - Dec 2004

Bibliographical note

Funding Information:
Supported by an unrestricted research grant from Amgen Inc., Thousand Oaks, California.

Copyright 2012 Elsevier B.V., All rights reserved.


  • Cohort studies
  • mortality
  • retrospective studies


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