The Influence of Age and Gender on Outcomes and Healthcare Cost Among Older Adults Hospitalized with Acute Systolic Heart Failure

Abstract

Background We aimed to evaluate the influence of age on clinical and economic outcomes in patients ≥75 years of age hospitalized for acute systolic heart failure (AHF). Methods From July 2017 to July 2017, among older adults ≥75 years of age, AHF visits were identified by the ICD-10 systolic heart failure code as any primary or secondary diagnosis in the Premier Healthcare Database, stratified by <75 years vs ≥75 years of age. Results Of 420,642 visits for AHF, 151,045 (36%) were for patients ≥75 years of age. Of these, 88,138 (58%) were male, 14,846 (10%) were Black, and 9,048 (6%) were Hispanic. The overall inpatient death rate was higher in older than younger patients (Death: 5.49% vs. 3.44%, p<0.001), but among patients ≥75 years, the mortality rate was consistently higher in males than females (Figure). The length of stay was greater among older patients (days: 4 vs. 3, p<0.001), and healthcare costs per visit was higher among older adults ($7,895 vs. $7,775, p<0.001). Conclusion In the U.S., in-hospital mortality attributed to AHF is highest among older male patients and accounts for significant societal healthcare cost. Methods to risk-stratify older patients presenting with AHF are needed to optimize healthcare delivery and utilization. We aimed to evaluate the influence of age on clinical and economic outcomes in patients ≥75 years of age hospitalized for acute systolic heart failure (AHF). From July 2017 to July 2017, among older adults ≥75 years of age, AHF visits were identified by the ICD-10 systolic heart failure code as any primary or secondary diagnosis in the Premier Healthcare Database, stratified by <75 years vs ≥75 years of age. Of 420,642 visits for AHF, 151,045 (36%) were for patients ≥75 years of age. Of these, 88,138 (58%) were male, 14,846 (10%) were Black, and 9,048 (6%) were Hispanic. The overall inpatient death rate was higher in older than younger patients (Death: 5.49% vs. 3.44%, p<0.001), but among patients ≥75 years, the mortality rate was consistently higher in males than females (Figure). The length of stay was greater among older patients (days: 4 vs. 3, p<0.001), and healthcare costs per visit was higher among older adults ($7,895 vs. $7,775, p<0.001). In the U.S., in-hospital mortality attributed to AHF is highest among older male patients and accounts for significant societal healthcare cost. Methods to risk-stratify older patients presenting with AHF are needed to optimize healthcare delivery and utilization.