Outcomes for older men and women with congestive heart failure

Risa B. Burns, Ellen P. McCarthy, Mark A. Moskowitz, Arlene Ash, Robert L Kane, Michael Finch

Research output: Contribution to journalArticlepeer-review

101 Scopus citations

Abstract

OBJECTIVES: To describe and compare outcomes for men and women discharged alive following a hospitalization for congestive heart failure (CHF). DESIGN: Prospective cohort study. PARTICIPANTS: A total of 519 patients, aged ≤ 65, who were discharged alive after a hospitalization for CHF (DRG = 127). MEASUREMENTS: Outcomes (Activities of Daily Living (ADLs), shortness of breath when walking, perceived health, living situation, rehospitalization, and mortality) were measured at 3 times (6 weeks, 6 months, and 1 year) postdischarge. RESULTS: The 205 men were, on average, younger (77 ± 7 vs 80 ± 8, P < .001), wealthier (46% vs 21% earned ≤ $10,000, P < .001), and more often married (50% vs 19%, P < .001). Men were more likely than women to have a previous history of CHF (71% vs 63%, P = .052). Men also had higher 1-year mortality than women (48% vs 35%, P = .009), even after adjusting for age, comorbidity, physiological severity (APACHE II APS and RAND discharge instability), radiological evidence of CHF, prior ADLs, walking ability, living situation, and perceived health. Men and women survivors at I year had similar and substantial impairment for all non fatal outcomes considered (all P values ≤ .489). Their adjusted mean ADL scores were consistent with complete dependence on one essential activity (range 0-6 dependencies); 35% were short of breath walking less than 1 block; 62% had fair or poor perceived health; 32% received some formal care; and 46% were rehospitalized within I year of discharge. CONCLUSIONS: Men with CHF have a higher mortality than women with UHF. Men and women who survive have similar and substantial impairment for all non-fatal outcomes(ADLs, shortness of breath upon walking, perceived health, living situation, and rehospitalization).

Original languageEnglish (US)
Pages (from-to)276-280
Number of pages5
JournalJournal of the American Geriatrics Society
Volume45
Issue number3
DOIs
StatePublished - Mar 1997

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