• Moritz Blum, Julia L Frydman, Li Zeng, Karen Hiensch, Abshire SaylorMarthaMCenter for Cardiovascular & Chronic Care, Johns Hopkins School of Nursing (M.A.S.), Baltimore, Maryland, USA., Emily Chai, Anuradha Lala, Nathan E Goldstein, and Laura P Gelfman.
• Brookdale Department of Geriatrics and Palliative Medicine (M.B., J.L.F., L.Z., K.H., E.C., N.E.G., L.P.G.), Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• J Pain Symptom Manage. 2024 Aug 8.

ContextPalliative care is increasingly recognized as an important aspect of heart failure (HF) management, but data on gender differences regarding palliative care needs are scarce.ObjectiveWe retrospectively studied patients hospitalized with a primary diagnosis of HF who received an initial palliative care consultation in the Mount Sinai Health System to examine gender differences.MethodsFrom electronic health records, we extracted patient information, diagnostic codes, and the palliative care consult assessment which included the Karnofsky performance status (KPS) and the Edmonton symptom assessment scale (ESAS). The population was stratified according to self-identified gender. Unadjusted and adjusted generalized linear models were fitted to study the association of gender with KPS and ESAS scores.ResultsAmong 667 patients with HF who received a palliative care consultation, 327 (49.0%) were women. Women with HF were older than men and less likely to be married. As compared to men, women had worse functional status, were less likely to have capacity to designate a surrogate medical decision-maker, had a higher symptom burden and were more likely to experience severe symptoms at the time of initial palliative care consultation. Differences in functional status and symptom burden were particularly pronounced in young women and women identifying as Black or Hispanic. The association of gender with functional status and symptom burden remained statistically significant after adjusting for possible confounders.ConclusionAs compared to men, women with HF were more severely impaired at the time of palliative care consult, and dedicated efforts to better address their needs are warranted.Copyright © 2024 American Academy of Hospice and Palliative Medicine. All rights reserved.

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