Age-specific trends and outcomes of hospitalizations with acute heart failure in the United States

Objective: To analyze the age-specific temporal trends, in-hospital outcomes and readmissions for acute heart failure (HF). Background: There is a paucity of data on the age-specific differences in the trends and outcomes of hospitalizations with acute HF. Methods: The National Inpatients Sample database years 2002–2016 and the National Readmissions Database years 2013–2016 were used to identify primary hospitalizations for acute HF. We analyzed the age-specific temporal trends, in-hospital outcomes, and readmissions for acute HF. Results: The annual rate of hospitalizations for acute HF declined from 456 per 100,000 people in 2002 to 356 per 100,000 people in 2016 (P_trend < 0.001). The decline was observed among all age groups, except those aged 18–44 years. There was a decline in in-hospital mortality among all age groups, except for those aged 18–34 years. Compared with 18–34 years, adjusted in-hospital mortality was lower among 35–44 years (odds ratio 0.78, 95% confidence interval [CI] 0.74–0.82) and 45–54 years (OR 0.87; 95% CI 0.83–0.91) but higher among 55–64 years (OR 1.60; 95% CI 1.54–1.67) and ≥ 75 year (OR 2.54; 95% CI 2.44–2.64). Compared with 18–34 years, 30-day HF-related readmissions were significantly lower in older age groups (>34 years). Conclusions: This nationwide contemporary analysis demonstrated a decline in the annual rates of hospitalizations with acute HF across all age categories except those aged 18–44 years. There was a reduction in rates of in-hospital mortality among middle-aged and older patients, but not in those aged 18–34. In-hospital mortality exhibited a dichotomous relationship with age. There was an inverse relationship between age and 30-days HF readmissions.