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Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF).
Am J Cardiol. 2009 Jul 01; 104(1):107-15.AJ

Abstract

Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care and patient outcomes by age and gender among a broad cohort of hospitalized patients with HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) is a registry and performance-improvement program involving 48,612 patients with HF from 259 hospitals. The data were analyzed by gender, age <75 years, and age > or =75 years. Appropriate angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker use were similar between women and men (p = 0.244 and p = 0.237, respectively). However, compared with men, fewer women received hospital discharge instructions (p <0.001) and the length of stay was longer (p <0.001). Risk-adjusted in-hospital and postdischarge mortality were similar. All guideline-recommended cardiac medications were prescribed less frequently at discharge to eligible patients > or =75 than to those <75 years (all p <0.001). Older age was independently associated with in-hospital and postdischarge mortality risk increases (76% and 62%, respectively; p <0.001 for both). In conclusion, among the OPTIMIZE-HF hospitals, female patients with HF generally received similar medical care and had similar risks of adverse clinical outcomes compared with male patients. Older patients with HF were less likely to receive guideline-recommended therapies and remained at greater risk of adverse outcomes.

Authors+Show Affiliations

Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Medical Center, Los Angeles, CA, USA. gfonarow@mednet.ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19576329

Citation

Fonarow, Gregg C., et al. "Age- and Gender-related Differences in Quality of Care and Outcomes of Patients Hospitalized With Heart Failure (from OPTIMIZE-HF)." The American Journal of Cardiology, vol. 104, no. 1, 2009, pp. 107-15.
Fonarow GC, Abraham WT, Albert NM, et al. Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF). Am J Cardiol. 2009;104(1):107-15.
Fonarow, G. C., Abraham, W. T., Albert, N. M., Stough, W. G., Gheorghiade, M., Greenberg, B. H., O'Connor, C. M., Sun, J. L., Yancy, C., & Young, J. B. (2009). Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF). The American Journal of Cardiology, 104(1), 107-15. https://doi.org/10.1016/j.amjcard.2009.02.057
Fonarow GC, et al. Age- and Gender-related Differences in Quality of Care and Outcomes of Patients Hospitalized With Heart Failure (from OPTIMIZE-HF). Am J Cardiol. 2009 Jul 1;104(1):107-15. PubMed PMID: 19576329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF). AU - Fonarow,Gregg C, AU - Abraham,William T, AU - Albert,Nancy M, AU - Stough,Wendy Gattis, AU - Gheorghiade,Mihai, AU - Greenberg,Barry H, AU - O'Connor,Christopher M, AU - Sun,Jie Lena, AU - Yancy,Clyde, AU - Young,James B, AU - ,, PY - 2008/11/26/received PY - 2009/02/17/revised PY - 2009/02/17/accepted PY - 2009/7/7/entrez PY - 2009/7/7/pubmed PY - 2009/7/25/medline SP - 107 EP - 15 JF - The American journal of cardiology JO - Am J Cardiol VL - 104 IS - 1 N2 - Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care and patient outcomes by age and gender among a broad cohort of hospitalized patients with HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) is a registry and performance-improvement program involving 48,612 patients with HF from 259 hospitals. The data were analyzed by gender, age <75 years, and age > or =75 years. Appropriate angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker use were similar between women and men (p = 0.244 and p = 0.237, respectively). However, compared with men, fewer women received hospital discharge instructions (p <0.001) and the length of stay was longer (p <0.001). Risk-adjusted in-hospital and postdischarge mortality were similar. All guideline-recommended cardiac medications were prescribed less frequently at discharge to eligible patients > or =75 than to those <75 years (all p <0.001). Older age was independently associated with in-hospital and postdischarge mortality risk increases (76% and 62%, respectively; p <0.001 for both). In conclusion, among the OPTIMIZE-HF hospitals, female patients with HF generally received similar medical care and had similar risks of adverse clinical outcomes compared with male patients. Older patients with HF were less likely to receive guideline-recommended therapies and remained at greater risk of adverse outcomes. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19576329/Age__and_gender_related_differences_in_quality_of_care_and_outcomes_of_patients_hospitalized_with_heart_failure__from_OPTIMIZE_HF__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)00678-X DB - PRIME DP - Unbound Medicine ER -