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The Effect of Age upon Care and Outcomes in Patients Hospitalized for Congestive Heart Failure in Alberta, Canada*

Published online by Cambridge University Press:  31 March 2010

Bibiana Cujec ,
Hude Quan ,
Yan Jin  and
David Johnson
Bibiana Cujec*
Affiliation:
Department of Medicine, University of Alberta
Hude Quan
Affiliation:
Department of Community Health Sciences, University of Calgary
Yan Jin
Affiliation:
Information Analysis, Alberta Health and Wellness
David Johnson
Affiliation:
Department of Health Sciences, University of Alberta
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Dr. Bibiana Cujec, Division of Cardiology, University of Alberta, 2C2.39 WMC, Edmonton, AB T6G 2B7. ([email protected])
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Abstract

We describe the age-specific outcomes for patients hospitalized with newly diagnosed congestive heart failure using administrative hospital abstracts from Alberta, Canada, from April 1, 1994, to March 31, 2000. Seniors (aged 65 years and older) constituted about 85 per cent of the 16,162 patients. Both co-morbidity and severity of illness tended to increase with age. The use of special care unit admissions, coronary artery diagnostic services (cardiac catheterization), and revascularization procedures (percutanenous transluminal coronary angioplasty/stenting, coronary artery bypass surgery) peaked in the 50-to 64-year age group and decreased with increasing age. Specialist/sub-specialist care, prescriptions of beta blockers and angiotensin-converting enzyme inhibitors / angiotensin receptor blockers decreased with age in seniors. Adjusted in-hospital, 1-year mortality and crude, age-specific 5-year mortality were significantly greater in those 75 years and older. Outcomes and process of care in patients with newly diagnosed congestive heart failure were not uniformly distributed with age. The elderly had greater mortality but received less therapy.

Résumé

Nous décrivons les résultats par âge des patients hospitalisés après un diagnostic récent d'insuffisance cardiaque globale, pour cela nous avons analysé les dossiers administratifs de divers hôpitaux situés en Alberta, au Canada, pour la période allant du 1er avril 1994 au 31 mars 2000. Près de 85 % des 16 162 patients sur lesquels portait l'étude étaient des personnes âgées (de 65 ans et plus). La comorbidité et la gravité de la maladie tendent à augmenter avec l'âge. L'admission en unité de soins spéciaux, les services de diagnostic des artères coronaires (cathétérisation cardiaque) et les procédures de revascularisation (angioplastie coronarienne transluminale percutanée/port de stents, pontage aortocoronarien) sont le plus courants chez les personnes âgées de 50 à 64 ans, mais deviennent moins fréquents chez les patients plus âgés. La prestation de soins de spécialistes/sous-spécialistes, la prescription de béta-bloquants et d'enzymes de conversion/d'inhibiteurs de l'angiotensine diminuent à mesure que les aînés avancent en âge. Les données comparatives, à l'hôpital, entre le taux de mortalité après un an et le taux brut de mortalité (par âge) après cinq ans sont considérablement plus élevés chez les personnes âgées de 75 ans et plus. Les résultats et la prise en charge des patients ayant récemment fait l'objet d'un diagnostic d'insuffisance cardiaque globale ne sont pas répartis uniformément selon l'âge : les personnes âgées ayant un taux de mortalité plus élevé, mais recevant moins de soins.

Keywords

aginghealth service utilizationcongestive heart failureseniorsvieillissementutilisation des services de santéinsuffisance cardiaque globalepersonnes âgées
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 3 , Fall/Automne 2004 , pp. 253 - 265
Copyright
Copyright © Canadian Association on Gerontology 2004

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Footnotes

*

This work was partially supported by the Alberta Centre for Health Service Utilization Research. The opinions and conclusions expressed in this paper are those of the authors and no endorsement by the Alberta Ministry of Health and Wellness is implied.

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