National Patterns of Heart Failure Hospitalizations and Mortality by Sex and Age

Abstract Background Earlier work has demonstrated significant sex and age disparities in ischemic heart disease. However, it remains unclear if an age or sex gap exists for heart failure (HF) patients. Methods and Results Using data from the 2007–2008 Healthcare Cost and Utilization Project, we cons...

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Bibliographic Details
Published in:Journal of cardiac failure 2013-08, Vol.19 (8), p.542-549
Main Authors: Rodriguez, Fátima, MD, MPH, Wang, Yun, PhD, Johnson, Caitlin E., BS, Foody, JoAnne M., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
age
Age Factors
Aged
Aged, 80 and over
Cardiovascular
Child
Child, Preschool
Databases, Factual - trends
disparities
Female
Heart failure
Heart Failure - diagnosis
Heart Failure - mortality
Heart Failure - therapy
Hospital Mortality - trends
Hospitalization - trends
Humans
Infant
Male
Middle Aged
outcomes research
sex
Sex Factors
United States - epidemiology
Young Adult
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Summary:Abstract Background Earlier work has demonstrated significant sex and age disparities in ischemic heart disease. However, it remains unclear if an age or sex gap exists for heart failure (HF) patients. Methods and Results Using data from the 2007–2008 Healthcare Cost and Utilization Project, we constructed hierarchic regression models to examine sex differences and age-sex interactions in HF hospitalizations and in-hospital mortality. Among 430,665 HF discharges, 51% were women and 0.3%, 27%, and 73% were aged 64 years respectively. There were significant sex differences among HF risk factors, with a higher prevalence of coronary disease among men. Men had higher hospitalization rates for HF and in-hospital mortality across virtually all ages. The relationship between age and HF mortality appeared U-shaped; mortality rates for ages 64 years were 2.9%, 1.4%, and 3.8%, respectively. No age-sex interaction was found for in-hospital mortality for adults >25 years old. Conclusions Using a large nationally representative administrative dataset we found age and sex disparities in HF outcomes. In general, men fared worse than women regardless of age. Furthermore, we found a U-shaped relationship between age and in-hospital mortality during an HF hospitalization, such that young adults have similar mortality rates to older adults. Additional studies are warranted to elucidate the patient-specific and treatment characteristics that result in these patterns.
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2013.05.016