OUTCOMES FOR OLDER MEN AND WOMEN WITH CONGESTIVE-HEART-FAILURE

OBJECTIVES: To describe and compare outcomes for men and women dischar ged alive following a hospitalization for congestive heart failure (CH F). DESIGN: Prospective cohort study PARTICIPANTS: A total of 519 pati ents, aged greater than or equal to 65, who were discharged alive afte r a hospitalization for CHF (DRG = 127). MEASUREMENTS: Outcomes (Activ ities of Daily Living (ADLs), shortness of breath when walking, percei ved health, living situation, rehospitalization, and mortality) were m easured at 3 times (6 weeks, 6 months, and 1 year) postdischarge.RESUL TS: The 205 men were, on average, younger (77 +/- 7 vs 80 +/- 8, P < . 001), wealthier (46% vs 21% earned greater than or equal to $10,000, P < .001), and more often married (50% vs 19%, P < .001). Men were more likely than women to have a previous history of CHF (71% vs 63%, P = .052). Men also had higher 1-year mortality than women (48% vs 35%, P = .009), even after adjusting for age, comorbidity, physiological seve rity (APACHE II APS and RAND discharge instability), radiological evid ence of CHF, prior ADLs, walking ability, living situation, and percei ved health. Men and women survivors at 1-year had similar and substant ial impairment for all non-fatal outcomes considered (all P values gre ater than or equal to .489). Their adjusted mean ADL scores were consi stent with complete dependence on one essential activity (range 0-6 de pendencies); 35% were short of breath walking less than 1 block; 62% h ad fair or poor perceived health; 32% received some formal care; and 4 6% were rehospitalized within 1 year of discharge. CONCLUSIONS: Men wi th CHF have a higher mortality than women with CHF. Men and women who survive have similar and substantial impairment for all non-fatal outc omes (ADLs, shortness of breath upon walking, perceived health, living situation, and rehospitalization).