Age, but not sex, influences the measurement of ejection fraction in elderly patients hospitalized for heart failure

Background: Current US and European guidelines recommend that ejection fraction (EF) be measured at least once in patients with congestive heart failure (CHF). However, it is not known how age and sex influence adherence to this recommendation. Methods: We reviewed a national sample of Medicare patients discharged with a principal diagnosis of heart failure and sought to determine the frequency of measurement of EF and the frequency of preserved systolic function (EF > 40%) by age and sex. Results: A total of 2,239 patients were included in this study. EF was known or measured in 59.2% of all admissions. EF was measured less often in women and with increasing age, but using logistic regression only increasing age (P < .0001) and not sex (P = .247) was associated with a lower frequency of EF measurement. Women were more likely than men to have preserved systolic function in all age groups older than age 65 (P < .001), but the frequency of preserved systolic function increased with age in both men and women. Conclusions: In Medicare patients discharged with a principal diagnosis of heart failure, only 59% have a measurement of EF. Women have EF measured less often than men; this is solely a function of the older age of women. Preserved systolic function increases in both men and women with CHF with increasing age, but women are far more likely than men to have preserved systolic function at all ages.