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May 1, 1997Journal of the American Geriatrics Society

The Sequelae of Hospitalization for Congestive Heart Failure Among Older Adults

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Why the study?

Does hospitalization for congestive heart failure increase mortality, rehospitalization, and functional decline in noninstitutionalized older adults aged 70 years or older?

Population

7,527 noninstitutionalized older adults aged 70 years or older at baseline from the nationally…

Comparison

Hospitalization for congestive heart failure vs Not having any CHF hospital discharge diagnoses

Design

Cohort

Follow-up

1984-1991 and three biennial follow-ups

Authors

FWFredric D. WolinskyUniversity of IowaDSDavid M. SmithNortheastern UniversityTSTimothy E. StumpMass General Brigham

Discussion

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Implication

CHF hospitalization signals higher mortality in older adults; leaves open whether targeted interventions modify risks.

Key Points

  • The study aims to estimate the effects of hospitalization for CHF on mortality, readmission rates, and functional status changes in older adults.
  • Secondary analysis of the Longitudinal Study on Aging data linked to Medicare records.
  • Sample includes 7527 noninstitutionalized older adults aged 70 years or older.
  • Multivariable regression models were used to analyze independent effects of CHF hospitalization.
  • Mortality risk increased (adjusted risk ratio 1.58, 95% CI 1.40 to 1.78, p < .001) post-CHF hospitalization.
  • Readmission rates for CHF ranged from 16.0 to 47.5% at 1 year.
  • Having primary or secondary discharge diagnoses of CHF led to substantially higher odds of subsequent hospitalization (adjusted odds ratio 7.70, 95% CI 6.20 to 9.57, p < .001).

Structured PICO

Does hospitalization for congestive heart failure increase mortality, rehospitalization, and functional decline in noninstitutionalized older adults aged 70 years or older?

P
Population
7,527 noninstitutionalized older adults aged 70 years or older at baseline from the nationally representative Longitudinal Study on Aging
I
Intervention
Hospitalization for congestive heart failure (defined as having one or more episodes with primary or secondary discharge ICD9-CM codes of 428)
C
Comparator
Not having any CHF hospital discharge diagnoses
O
Outcome
Mortality, readmission for CHF, rehospitalization for any reason, and change in functional statushard clinical

Hospitalization for congestive heart failure in older adults is associated with a significantly increased risk of subsequent mortality, rehospitalization, and functional decline.

Cite This Study

Wolinsky et al. (1997) studied this question.

synapsesocial.com/papers/6a101a91d13714ec96ff2bf5https://doi.org/10.1111/j.1532-5415.1997.tb03087.x

Topics

Heart failureHFrEF treatmentHeart failure hospitalization
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Medical Therapy and Prognosis in Chronic Heart Failure1995 · 10 citations
  2. 2An Epidemiology of Disability among Adults in the United States1976 · 1,432 citations
  3. 3The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study.1997 · 453 citations
  4. 4Effect of DRGs on three-month readmission rate of geriatric patients with congestive heart failure.1988 · 120 citations