Age-Related Differences in Clinical Predictors of 1 Year Death Rates: The Worcester Heart Failure Study

Background: Congestive heart failure (CHF) remains one of the leading causes of morbidity and mortality in the United States. The objective of this study is to describe clinical factors associated with one year mortality between the old, older, and oldest adults after hospitalization for acute CHF.

Methods: The Worcester Heart Failure Study is a population based study of residents of the Worcester (MA) Metropolitan Area hospitalized with acute HF at area medical centers (n=11) during 1995-2000. We used a multivariate logistic regression analysis to examine the association of selected clinical factors with death at one year after hospital discharge in three age-specific cohorts.

Main results: Among those 65-74 years of age: a lower BMI, lower hematocrit, lower systolic blood pressure, lack of chest pain at presentation, and the presence of edema or orthopnea at presentation with an increase risk of dying. Among those 75-85 years of age: White race, lower BMI, lack of anemia, the presence of prior CAD or HF, an elevated BUN, lower systolic blood pressure, lack of chest pain at presentation, and the presence of weakness at presentation were associated with increased 1 year death rates. Among those 85 years of age and older: White race, previous heart failure, elevated BUN, and lower systolic blood pressure were associated with 1 year death rates.

Conclusions: The results of this community-wide study demonstrate differences in the clinical factors associated with death at one year post-discharge between the old, older and oldest adults hospitalized for acute HF.