Admission characteristics predicting longer length of stay among elderly patients hospitalized for decompensated heart failure.
BACKGROUND
Acutely decompensated heart failure (HF) has become the leading cause of hospitalization for people aged 65 or older. Hospital length of stay (LOS) is a key determinant of higher hospitals costs. The aim of our study is to identify the admission characteristics that predict a longer LOS for elderly patients admitted for an acute exacerbation of HF.


METHODS
We prospectively evaluated 324 patients (65 years of age or older), who were consecutively admitted for decompensated HF to a tertiary teaching hospital. Variables present at the time of emergency room evaluation that could predict a longer hospital LOS were determined by comparing the characteristics of patients hospitalized for less than 4 days with those of patients needing a longer stay.


RESULTS
There were 191 women (59%) and 133 men in the study, with an average age of 78.6 years and a mean LOS of 7.1 days. Multivariate regression models identified two independent predictors of a hospital stay longer than four days: female gender (p=0.03, OR 1.645, 95% CI 1.047-2.584) and poorer NYHA functional class (p<0.01, OR 1.699, 95% CI 1.135-2.542).


CONCLUSIONS
In elderly patients admitted for decompensated HF, the female gender and a worse functional class at the time of admission were associated with a longer subsequent LOS.
Formiga
Francesc
F
Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat 08907, Barcelona, Spain. fformiga@csub.scs.es
Chivite
David
D
Manito
Nicolas
N
Mestre
Antoni Riera
AR
Llopis
Ferran
F
Pujol
Ramon
R
D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology