4.6 Article

Clinical features of heart failure hospitalization in younger and elderly patients in Taiwan

Journal

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
Volume 41, Issue 6, Pages 597-604

Publisher

WILEY-BLACKWELL
DOI: 10.1111/j.1365-2362.2010.02447.x

Keywords

Comorbidity; heart failure; hospitalization; in-hospital mortality; medical expense

Funding

  1. New Century Health Care Promotion Foundation
  2. National Genotyping Center of National Research Program for Genomic Medicine, National Science Council
  3. Department of Health [DOH89-TD-1035, DOH97-TD-D-113-97009]
  4. National Taiwan University Hospital Yun-Lin Branch [NTUHYL96.G001]
  5. National Science Council [NSC-86-2314-B-002-326, NSC-87-2314-B-002-245, NSC88-2621-B-002-030, NSC89-2320-B002-125, NSC-90-2320-B-002-197, NSC-92-2320-B-002-156, NSC-93-2320-B-002-071, NSC-94-2314-B-002-142, NSC-95-2314-B-002-311, NSC-96-2314-B-002-061-MY2]

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P>Background This study compared the comorbidities, drugs, expenses and in-hospital mortality between younger and elderly patients hospitalized with heart failure. Methods A random sample of 1 000 000 insurants of the National Health Insurance program of Taiwan in 2005 was used. Comparisons were made between younger (20-64 years) and elderly (>= 65 years) patients. Results Heart failure hospitalization was identified in 2692 patients. Ageing, female sex, diabetes, hypertension, chronic obstructive pulmonary disease, nephropathy, infection and ischaemic heart disease were significantly associated with heart failure hospitalization. The incidence was 88 and 2181 per 100 000 population, in younger and elderly people, respectively. The most common comorbidity in the elderly was hypertension (38 center dot 3%), followed by infection (32 center dot 0%) and ischaemic heart disease (31 center dot 9%). In younger patients, hypertension (41 center dot 3%), diabetes (35 center dot 5%) and ischaemic heart disease (29 center dot 8%) were the most common comorbidity. Diuretics were the most common drugs for both the younger (74 center dot 4%) and the elderly (76 center dot 9%) patients, followed by angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers and aspirin. The length of stay was longer (17 center dot 1 vs. 11 center dot 0 days, P < 0 center dot 0001), total expense higher (105 290 center dot 5 vs. 85 473 center dot 6 New Taiwan Dollars, P < 0 center dot 05) and in-hospital mortality higher (4 center dot 2% vs. 2 center dot 7%, P = 0 center dot 0823) in the elderly. Length of stay, nephropathy, infection, ischaemic heart disease and peripheral arterial disease were associated with expenses. In-hospital mortality was associated with age, length of stay, cancer, infection and peripheral arterial disease. Conclusions The elderly have a 25-fold higher risk of heart failure hospitalization, longer length of in-hospital stay, higher total medical expense and higher in-hospital mortality.

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