Open Access Research article

Age- and gender-specific risk of death after first hospitalization for heart failure

I Vaartjes1*, AW Hoes1, JB Reitsma2, A de Bruin3, DE Grobbee1, A Mosterd145 and ML Bots1

Author Affiliations

1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

2 Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands

3 Statistics Netherlands, The Hague, The Netherlands

4 Department of Cardiology, University Medical Center Utrecht, Utrecht

5 Department of Cardiology, Meander Medical Center, Amersfoort, The Netherlands

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BMC Public Health 2010, 10:637  doi:10.1186/1471-2458-10-637

Published: 22 October 2010

Abstract

Background

Hospitalization for heart failure (HF) is associated with high-in-hospital and short- and long-term post discharge mortality. Age and gender are important predictors of mortality in hospitalized HF patients. However, studies assessing short- and long-term risk of death stratified by age and gender are scarce.

Methods

A nationwide cohort was identified (ICD-9 codes 402, 428) and followed through linkage of national registries. The crude 28-day, 1-year and 5-year mortality was computed by age and gender. Cox regression models were used for each period to study sex differences adjusting for potential confounders (age and comorbidities).

Results

14,529 men, mean age 74 ± 11 years and 14,524 women, mean age 78 ± 11 years were identified. Mortality risk after admission for HF increased with age and the risk of death was higher among men than women. Hazard ratio's (men versus women and adjusted for age and co-morbidity) were 1.21 (95%CI 1.14 to 1.28), 1.26 (95% CI 1.21 to 1.31), and 1.28 (95%CI 1.24 to 1.31) for 28 days, 1 year and 5 years mortality, respectively.

Conclusions

This study clearly shows age- and gender differences in short- and long-term risk of death after first hospitalization for HF with men having higher short- and long-term risk of death than women. As our study population includes both men and women from all ages, the estimates we provide maybe a good reflection of 'daily practice' risk of death and therefore be valuable for clinicians and policymakers.