title: Dichotomous Relationship Between Age and 30-Day Death or Rehospitalization in Heart Failure Patients Admitted With Acute Decompensated Heart Failure: Results From the ASCEND-HF Trial.
abstract: BACKGROUND
  Younger age as an independent predictor of death or all-cause rehospitalization at 30 days post-randomization for hospitalized heart failure (HF) patients has not been well described.
  
  
  RESULTS
  ASCEND-HF enrolled 7141 hospitalized acute HF patients (categorized by age: <45, 45 to <55, 55 to <65, 65 to <75, and ≥75 years) and followed them for 30 days to assess clinical outcomes, which included death or rehospitalization. Patients 45 to <55 years had the lowest percentages of death (1.4%) and total rehospitalizations (10.7%); percentages increased for younger (3.0% and 12.2%, respectively, for age <45 y) and older (5.8% and 12.5%, respectively, for age ≥75 y) patients. For those rehospitalized, the total HF-induced readmissions were highest in the youngest (68%) and declined with increasing age (P = .03). Although patients ≥55 years of age were more likely to die or be rehospitalized within 30 days of randomization for each additional 10 years of life, those <55 years of age had a significant reduction in death or HF rehospitalization for each 10-year increase in age (similar findings for death and HF rehospitalization).
  
  
  CONCLUSIONS
  There is a dichotomous relationship between age and risk of death or rehospitalization, and death or HF rehospitalization-risk decreases as age increases up to age 55 years, then increases after age 55 years.
authors.affiliation: Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA. Electronic address: david.whellan@jefferson.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Whellan
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Stebbins
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.affiliation: Canadian VIGOUR Centre at the University of Alberta, Mazankowski Alberta Heart Institute, Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ezekowitz
authors.affiliation: Western Infirmary and the British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom.
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.affiliation: Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mather
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Vic
authors.initials: V
authors.lastname: Hasselblad
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: O'Connor
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D002423:Cause of Death / Q000639:trends; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Heart failure; age; outcomes; rehospitalization