Patterns of Comorbidity in Older Adults with Heart Failure:: The Cardiovascular Research Network PRESERVE Study

• Autores: Jane S. Saczynski, Alan S. Go, David J. Magid, David J. Smith, David D. McManus, Larry Allen, Jessica Ogarek, Robert J. Goldberg, Jerry H. Gurwitz
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 1, 2013, págs. 26-33
• Idioma: inglés
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• Resumen

  • Objectives: To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R).

    Design: Cross-sectional cohort study.

    Setting: Four participating health plans within the National Heart, Lung, and Blood Institute�sponsored Cardiovascular Research Network.

    Participants: All members aged 65 and older with HF based on hospital discharge and ambulatory visit diagnoses.

    Measurements: Participants with a LVEF of 50% or greater were classified as having HF-P. Presence of cardiac and noncardiac comorbidities was obtained from health plan administrative databases.

    Results: Of 23,435 individuals identified with HF and LVEF information, 53% (12,407) had confirmed HF-P (mean age 79.6; 60% female). More than three-quarters of the sample had three or more co-occurring conditions in addition to HF, and half had five or more cooccurring conditions. Participants with HF-P had a slightly higher burden of comorbidity than those with HF-R (mean 4.5 vs 4.4, P = .002). Patterns of how specific conditions co-occurred did not vary in participants with preserved or reduced systolic function.

    Conclusion: There is a high degree of comorbidity and multiple morbidity in individuals with HF. The burden and pattern of comorbidity varies only slightly in individuals with preserved or reduced LVEF.