AIMS:
Globally rates of heart failure admissions are increasing with an aging population. This study will describe the differences in demographics, clinical characteristics, rates of guideline directed medical therapy (GDMT), readmission rates and mortality in those over 80 years compared to those under 80 years admitted with decompensated heart failure before and after the implementation of a heart failure telehealth clinic.
METHODS:
All patients admitted to one tertiary centre with a diagnosis of heart failure between July 2021 and June 2024 were included.
RESULTS:
The average age in those over 80 years was 87 years (SD 4.4) with higher numbers of females (57.7% vs 38.6%, p < 0.01) and heart failure preserved ejection fraction (50.5% vs 26.6%, p <0.01). In patients with heart failure reduced ejection fraction there were lower rates of GDMT on discharge in those over 80 years both pre (21.8% vs 60.4%, p<0.01) and post clinic implementation (26.7% vs 62.6%, p<0.01). There was a statistically significant reduction in 30-day emergency department (ED) readmissions in those over 80 years post clinic implementation (25% vs 8.5%, p<0.001). Iron infusions were associated with reduced odds of 30-day heart failure readmissions (0.44, 95%CI 0.219-0.869, p=0.02) and mortality at one year (0.34, 95%CI 0.144-0.806, p=0.01).
CONLUSION:
This study has shown statistically significant differences in demographics and clinical characteristics for patients over 80 years, along with lower rates of GDMT. There was a reduction in 30-day ED readmissions post clinic implementation. Further research is required into interventions that improve outcomes in this population.