Death Rate Declining for Elders With Heart Failure
But Study Shows Readmission to Hospital for Heart Failure Is Still Frequent
April 5, 2011 -- Death rates after hospitalization for patients 80 and older with heart failure have dropped significantly in the past decade, but readmissions for the disorder -- common among the elderly -- are frequent, a new study shows.
Heart failure is one of the most common reasons older patients are readmitted to hospitals. This is not likely to change in coming years, in part because people 80 and older make up the fastest growing segment of the older population.
Researchers studied 21,397 U.S. veterans aged 80 and older who had been hospitalized at least once for heart failure from 1999 through 2008.
The outcomes of those patients were analyzed according to three age groups: 80 to 84, 85 to 89, and 90 or older.
Tracking Heart Failure Outcomes
The researchers say they found that overall death rates within 30 days of the first recorded hospitalization for heart failure were cut in half, from 14% to 7%, in the 1999-2008 time period.
The hospital readmission rate for any cause within 30 days of the initial hospitalization for heart failure was 17.3% and remained mostly unchanged between 1999 and 2008.
Overall death rates within a year of the first hospitalization for heart failure fell from 48.8% to 27.2%.
Patients 90 and older with heart failure were the most likely to die within a year of first admission.
However, in the 90 and older age group, 30-day death rates fell 11%, and one-year death rates dropped 26%, according to the study. And the biggest improvements in survivability occurred in that age group.
The researchers say the drop in death rates could be due to a growing emphasis in recent years on performance measures that promote evidence-based treatment of heart failure.
Because the study included only veterans -- and only 2.6% of participants were female -- the findings do not necessarily apply to broader populations, says study researcher Rashmee Shah, MD, a post-doctoral fellow at Stanford University School of Medicine.
Expected Impact of Aging Population
In general, elderly heart failure patients are defined as those who are only 65 or older, and the average age at diagnosis is 75 and up. This population is sure to increase dramatically in number with the aging of the baby boom generation.
The number of Americans age 80 and older is projected to grow to 21 million over the next 40 years. Shah says a number of steps could, in theory, reduce the risk of short-term readmissions among very elderly heart failure patients.
These could include better patient education, blood testing, or other follow-up procedures by doctors shortly after heart failure patients are discharged from hospitals, Shah says.
“The next step would be another investigation to see what’s driving the readmissions and test interventions to reduce readmissions among this growing population,” Shah says.
The study is published April 5 in Circulation: Heart Failure, a journal of the American Heart Association.