Evidence map›Paper›PMID 30187290›Full record

ArticleDrugs & aging2018

Lower Prescription Rates in Centenarians with Heart Failure and Heart Failure and Kidney Disease Combined: Findings from a Longitudinal Cohort Study of Very Old Patients.

Insa Marie Schmidt, Reinhold Kreutz, Dagmar Dräger, Christine Zwillich, Stefan Hörter, Adelheid Kuhlmey, Paul Gellert

Abstract read
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In one paragraph

Article in Drugs & aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  6. Does Superior Bone Health Promote a Longer Lifespan?Geriatric orthopaedic surgery & rehabilitation · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Insa Marie SchmidtInstitute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Berlin, Germany. insa-marie.schmidt@charite.de.
Reinhold KreutzInstitute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Dagmar DrägerInstitute of Medical Sociology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Christine ZwillichInstitute for Health Care Research of the Knappschaft, Knappschaft, Bochum, Germany.
Stefan HörterInstitute for Health Care Research of the Knappschaft, Knappschaft, Bochum, Germany.
Adelheid KuhlmeyInstitute of Medical Sociology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Paul GellertInstitute of Medical Sociology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Charité - Universitätsmedizin Berlin · DEUniversitätsklinikum Knappschaftskrankenhaus Bochum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCentenarians are considered as models of successful aging and represent a special group of patients. The aim of this study was to analyze heart failure epidemiology and treatment trajectories in centenarians compared to nonagenarians (90-99 years of age) and octogenarians (80-89 years of age) with heart failure and with heart failure and kidney disease combined.

methodsThis cohort study used quarterly structured routine data from 1398 German insurants over 6 years prior to death (398 centenarians were compared with 500 nonagenarians and 500 octogenarians). Of those, 525 individuals were diagnosed with heart failure before death; 164 had heart failure and kidney disease combined. Generalized estimation equations were used to assess the association of diagnoses of heart failure and other diseases with medication prescriptions.

resultsAcross age groups, heart failure was significantly more prevalent in centenarians compared with octogenarians and nonagenarians. Prevalence of heart failure increased over time. Female sex [odds ratio (men) = 0.70, p = 0.024], kidney disease (odds ratio = 1.31, p < 0.001), and hypertension (odds ratio = 1.52, p < 0.001) were all associated with heart failure. Overall, heart failure treatment changed significantly over time with an increased prescription rate of loop diuretics and a decreased rate of renin-angiotensin-system inhibitors. Centenarians were significantly less likely to receive treatment with renin-angiotensin-system inhibitors, loop diuretics, or beta-blockers compared with nonagenarians and octogenarians. Furthermore, aldosterone inhibitors were seldom prescribed; If-channel and neprilysin inhibitors were not routinely used in our sample. For those with heart failure and kidney disease combined, our data revealed that the prevalence of kidney disease was lower in centenarians than in younger patients before death. However, differences in prescription rates across age groups were non-significant, although numerically large. Finally, half of the patients in all three age groups with heart failure and kidney disease received treatment with renin-angiotensin-system inhibitors; about two out of five patients received beta-blockers, while prescription rates of aldosterone inhibitors were low.

conclusionsWhile heart failure prevalence shows a continuous increase with age, prescription rates are lower in centenarians, emphasizing the need for further studies considering the quality of care and outcomes in this patient population. Disease management programs and trials are needed to develop guidelines that address the medically challenging treatment for very old patients with comorbid heart failure and kidney disease.

Indexed as

Aged, 80 and overAge FactorsCohort StudiesComorbidityDrug PrescriptionsFemaleHeart FailureHumansHypertensionKidney DiseasesLongitudinal StudiesMaleOdds Ratio

Identifiers

PMID30187290
OpenAlexW2889854932

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.