• Jane S Saczynski, Chad E Darling, Frederick A Spencer, Darleen Lessard, Joel M Gore, and Robert J Goldberg.
• Department of Medicine, Division of GeriatricMedicine, University of Massachusetts Medical School, Biotech Four, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. jane.saczynski@umassmed.edu
• J Am Geriatr Soc. 2009 Sep 1;57(9):1587-94.

ObjectivesTo examine age-specific differences in clinical presentation, receipt of therapeutic practices and lifestyle recommendations, and hospital and long-term survival in patients hospitalized for acute heart failure HF.DesignPopulation-based study.SettingThe Worcester Heart Failure Study, a population-based study of residents of the a large Central New England metropolitan area hospitalized for decompensated HF at 11 greater-Worcester medical centers.ParticipantsFour thousand five hundred thirty-four patients hospitalized for decompensated HF during 1995 and 2000.MeasurementsMedical records were reviewed for demographic, clinical, and treatment characteristics and hospital survival status. Long-term follow-up of discharged hospital patients was conducted through 2005. Patients were compared according to four age groups (<65, 65-74, 75-84, and > or =85).ResultsMean age was 76; 24.0% were aged 85 and older. Patients aged 75 and older were more likely to be female and to have multiple comorbidities, a lower body mass index at the time of hospitalization, and higher ejection fraction findings. Older patients were significantly more likely to receive symptom-modifying medications and less likely to receive disease-modifying medications than younger patients. Older age was directly associated with higher in-hospital, 30-day, and 1-year death rates in crude and multivariable-adjusted analyses.ConclusionThe results of this community-wide study suggest that clinical, treatment, and prognostic factors differ according to age in patients hospitalized for decompensated HF. These high-risk patients warrant special attention in future studies to improve their management and long-term survival.

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