Admission characteristics predicting longer length of stay among elderly patients hospitalized for decompensated heart failure

Eur J Intern Med. 2008 May;19(3):198-202. doi: 10.1016/j.ejim.2007.09.007. Epub 2007 Oct 26.


Background: Acutely decompensated heart failure (HF) has become the leading cause of hospitalization for people aged 65 or older. Hospital length of stay (LOS) is a key determinant of higher hospitals costs. The aim of our study is to identify the admission characteristics that predict a longer LOS for elderly patients admitted for an acute exacerbation of HF.

Methods: We prospectively evaluated 324 patients (65 years of age or older), who were consecutively admitted for decompensated HF to a tertiary teaching hospital. Variables present at the time of emergency room evaluation that could predict a longer hospital LOS were determined by comparing the characteristics of patients hospitalized for less than 4 days with those of patients needing a longer stay.

Results: There were 191 women (59%) and 133 men in the study, with an average age of 78.6 years and a mean LOS of 7.1 days. Multivariate regression models identified two independent predictors of a hospital stay longer than four days: female gender (p=0.03, OR 1.645, 95% CI 1.047-2.584) and poorer NYHA functional class (p<0.01, OR 1.699, 95% CI 1.135-2.542).

Conclusion: In elderly patients admitted for decompensated HF, the female gender and a worse functional class at the time of admission were associated with a longer subsequent LOS.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Demography
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Geriatric Assessment
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Heart Failure / therapy*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Patient Admission / statistics & numerical data
  • Prospective Studies
  • Severity of Illness Index
  • Sex Factors
  • Spain / epidemiology