0481: Clinical profile of patients hospitalized for acute heart failure in cardiology and in geriatrics. A survey in greater Paris University hospitals

Abstract

Acute heart failure is a major cause of hospitalizations, particularly in patients over 65 years. The purpose of this analysis was to compare medical demographics of patients referred to cardiology departments and those referred to geriatric departments. Consecutive patients hospitalized for acute heart failure were included in 10 cardiology departments (CD, n=192) and 4 geriatrics departments (GD, n=65) between September 2014 and February 2015. There was no difference in duration of hospital stay (13.1±12.7 vs 11.3±5.6 days, p=0.7). Mean age was different between CD and GD (73.1±15 vs 89.1±5.7 years, p<0.0001) with a greater proportion of women in GD (37% versus 65%, p=0.0006). Comorbidities were more frequent in geriatric population (p=0.0004). Geriatric patients were more often staying in long stay institutions (13% vs 2.7% p<0.0017) or were living alone with medical support (29% vs 16% p<0.02). Cognitive disorders and falls were more prevalent (47% vs 9%, p<0.0001 and 19% vs 3%, p<0.0001 respectively) and there was a trend for more depressions. Infection was a much more frequent trigger (56% vs 16%, p<0.0001) whereas poor compliance was similar in the two subgroups (16%). Patients referred to geriatrics were more likely to be referred by a general practitioner (23% vs 13%, ns) and by emergency departments (76% vs 28% p=0.016) and less likeky to stay in an intensive care unit (13% versus 48%) and to receive nitrates or inotropic support. Fewer patients in geriatrics were discharged home (51% vs 69%, p<0.0001) with more home medical support (43% vs 13% p<0.0001) and more were referred to rehabilitation centers (37% vs 16%, p=0.008). Patients referred to geriatrics departments for acute heart failure have a different patient journey from those referred to cardiology departments. The high prevalence of cognitive disorders makes management of this condition complex and often requires home medical support.