Outcomes for older men and women with congestive heart failure.
OBJECTIVE
To describe and compare outcomes for men and women discharged alive following a hospitalization for congestive heart failure (CHF).


METHODS
Prospective cohort study.


METHODS
A total of 519 patients, aged > or = 65, who were discharged alive after a hospitalization for CHF (DRG = 127).


METHODS
Outcomes (Activities of Daily Living (ADLs), shortness of breath when walking, perceived health, living situation, rehospitalization, and mortality) were measured at 3 times (6 weeks, 6 months, and 1 year) post-discharge.


RESULTS
The 205 men were, on average, younger (77 +/- 7 vs 80 +/- 8, P < .001), wealthier (46% vs 21% earned > or = $10,000, P < .001), and more often married (50% vs 19%, P < .001). Men were more likely than women to have a previous history of CHF (71% vs 63%, P = .052). Men also had higher 1-year mortality than women (48% vs 35%, P = .009), even after adjusting for age, comorbidity, physiological severity (APACHE II APS and RAND discharge instability), radiological evidence of CHF, prior ADLs, walking ability, living situation, and perceived health. Men and women survivors at 1-year had similar and substantial impairment for all non-fatal outcomes considered (all P values > or = .489). Their adjusted mean ADL scores were consistent with complete dependence on one essential activity (range 0-6 dependencies); 35% were short of breath walking less than 1 block; 62% had fair or poor perceived health; 32% received some formal care; and 46% were rehospitalized within 1 year of discharge.


CONCLUSIONS
Men with CHF have a higher mortality than women with CHF. Men and women who survive have similar and substantial impairment for all non-fatal outcomes (ADLs, shortness of breath upon walking, perceived health, living situation, and rehospitalization).
Burns
R B
RB
Section of General Internal Medicine, Evans Department of Medicine, Boston University Medical Center Hospital, MA 02118-2334, USA.
McCarthy
E P
EP
Moskowitz
M A
MA
Ash
A
A
Kane
R L
RL
Finch
M
M
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis