Age-specific trends and outcomes of hospitalizations with acute heart failure in the United States.

OBJECTIVE

To analyze the age-specific temporal trends, in-hospital outcomes and readmissions for acute heart failure (HF).

BACKGROUND

There is a paucity of data on the age-specific differences in the trends and outcomes of hospitalizations with acute HF.

METHODS

The National Inpatients Sample database years 2002-2016 and the National Readmissions Database years 2013-2016 were used to identify primary hospitalizations for acute HF. We analyzed the age-specific temporal trends, in-hospital outcomes, and readmissions for acute HF.

RESULTS

The annual rate of hospitalizations for acute HF declined from 456 per 100,000 people in 2002 to 356 per 100,000 people in 2016 (P < 0.001). The decline was observed among all age groups, except those aged 18-44 years. There was a decline in in-hospital mortality among all age groups, except for those aged 18-34 years. Compared with 18-34 years, adjusted in-hospital mortality was lower among 35-44 years (odds ratio 0.78, 95% confidence interval [CI] 0.74-0.82) and 45-54 years (OR 0.87; 95% CI 0.83-0.91) but higher among 55-64 years (OR 1.60; 95% CI 1.54-1.67) and ≥ 75 year (OR 2.54; 95% CI 2.44-2.64). Compared with 18-34 years, 30-day HF-related readmissions were significantly lower in older age groups (>34 years).

CONCLUSIONS

This nationwide contemporary analysis demonstrated a decline in the annual rates of hospitalizations with acute HF across all age categories except those aged 18-44 years. There was a reduction in rates of in-hospital mortality among middle-aged and older patients, but not in those aged 18-34. In-hospital mortality exhibited a dichotomous relationship with age. There was an inverse relationship between age and 30-days HF readmissions.