What does this research mean for the field?

Older adults with newly diagnosed heart failure exhibit four distinct 5-year hospitalization trajectories that can be predicted at the time of diagnosis using routinely available clinical characteristics. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Identify long-term trajectories of all-cause hospitalizations after a new diagnosis of heart failure in older adults and determine whether high-risk patients can be predicted before discharge.

September 18, 2026The Journals of Gerontology Series A

Longitudinal Trajectories of Hospitalizations in U.S. Older Adults with Heart Failure

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Heart failure (n=84597). Intervention: Baseline clinical characteristics vs. Low-risk patients (Group 1). Primary outcome: Trajectories of all-cause hospitalizations.

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Population

84,597 fee-for-service Medicare beneficiaries with newly-diagnosed heart failure during an inpatient stay…

Design

Cohort

Follow-up

up to 5 years

Key result

Baseline clinical characteristics predicted four distinct long-term hospitalization trajectories in newly-diagnosed heart failure patients, with model C-statistics ranging from 0.65 to 0.79.

Authors

HXHanzhang Xu RDRadha Dhingra BHBradley G. Hammill

Discussion

Member takes

Overview

May guide post-discharge monitoring in older HF patients via predicted trajectories; hypothesis-generating for targeted interventions pending validation.

Key Points

Identify long-term trajectories of all-cause hospitalizations after a new diagnosis of heart failure in older adults and determine whether high-risk patients can be predicted before discharge.
Retrospective cohort study of 84,597 fee-for-service Medicare beneficiaries (mean age 77.4 ± 7.1 years, 58.3% male) newly diagnosed with heart failure during an inpatient stay (2010–2020) and followed up to 5 years.
Group-based trajectory models (GBTM) mapped all-cause hospitalization trajectories, and LASSO regression predicted trajectory assignment based on baseline characteristics.
Model discrimination was evaluated with C-statistics, and calibration was assessed using expected-to-observed ratios.
Patients fell into 4 hospitalization trajectories: Group 1 (consistently low risk; n = 19,340, 22.9%), Group 2 (high-to-low risk; n = 53,922, 57.9%), Group 3 (low-to-high risk; n = 5,035, 9.8%), and Group 4 (consistently high risk; n = 6,300, 9.4%).
Compared to Group 1, prediction models achieved C-statistics of 0.65 for Group 2, 0.68 for Group 3, and 0.79 for Group 4, with superior discrimination in patients ≤70 years and calibration ratios near 1.0 across subgroups.

Study Design

Type

Cohort (n=84,597)

Multicenter

Yes

Structured PICO

Population

84,597 U.S. Medicare beneficiaries (mean age 77.4 years) with newly-diagnosed heart failure during an inpatient stay, followed for up to 5 years.

Outcome

Trajectories of all-cause hospitalizations during follow-up (up to 5 years)hard clinical

Older adults with newly diagnosed heart failure follow four distinct long-term hospitalization trajectories that can be predicted at the time of diagnosis using routine clinical characteristics.

Cite This Study

Xu et al. (2026) conducted a cohort in Heart failure (n=84,597). Baseline clinical characteristics vs. Low-risk patients (Group 1) was evaluated on Trajectories of all-cause hospitalizations. Baseline clinical characteristics predicted four distinct long-term hospitalization trajectories in newly-diagnosed heart failure patients, with model C-statistics ranging from 0.65 to 0.79.

synapsesocial.com/papers/6aacf5ed0c46fbdff987dd68 https://doi.org/10.1093/gerona/glag233

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September 18, 2026The Journals of Gerontology Series A

Longitudinal Trajectories of Hospitalizations in U.S. Older Adults with Heart Failure

View Full Paper

Ask AI

Bookmark

Population

84,597 fee-for-service Medicare beneficiaries with newly-diagnosed heart failure during an inpatient stay…

Design

Cohort

Follow-up

up to 5 years

Key result

Baseline clinical characteristics predicted four distinct long-term hospitalization trajectories in newly-diagnosed heart failure patients, with model C-statistics ranging from 0.65 to 0.79.

Authors

HXHanzhang Xu RDRadha Dhingra BHBradley G. Hammill

Discussion

Member takes

Overview

May guide post-discharge monitoring in older HF patients via predicted trajectories; hypothesis-generating for targeted interventions pending validation.

Key Points

Identify long-term trajectories of all-cause hospitalizations after a new diagnosis of heart failure in older adults and determine whether high-risk patients can be predicted before discharge.
Retrospective cohort study of 84,597 fee-for-service Medicare beneficiaries (mean age 77.4 ± 7.1 years, 58.3% male) newly diagnosed with heart failure during an inpatient stay (2010–2020) and followed up to 5 years.
Group-based trajectory models (GBTM) mapped all-cause hospitalization trajectories, and LASSO regression predicted trajectory assignment based on baseline characteristics.
Model discrimination was evaluated with C-statistics, and calibration was assessed using expected-to-observed ratios.
Patients fell into 4 hospitalization trajectories: Group 1 (consistently low risk; n = 19,340, 22.9%), Group 2 (high-to-low risk; n = 53,922, 57.9%), Group 3 (low-to-high risk; n = 5,035, 9.8%), and Group 4 (consistently high risk; n = 6,300, 9.4%).
Compared to Group 1, prediction models achieved C-statistics of 0.65 for Group 2, 0.68 for Group 3, and 0.79 for Group 4, with superior discrimination in patients ≤70 years and calibration ratios near 1.0 across subgroups.

Study Design

Type

Cohort (n=84,597)

Multicenter

Yes

Structured PICO

Population

84,597 U.S. Medicare beneficiaries (mean age 77.4 years) with newly-diagnosed heart failure during an inpatient stay, followed for up to 5 years.

Outcome

Trajectories of all-cause hospitalizations during follow-up (up to 5 years)hard clinical

Older adults with newly diagnosed heart failure follow four distinct long-term hospitalization trajectories that can be predicted at the time of diagnosis using routine clinical characteristics.

Cite This Study

synapsesocial.com/papers/6aacf5ed0c46fbdff987dd68 https://doi.org/10.1093/gerona/glag233

View Full Paper

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