Consecutive patients hospitalized for acute heart failure were included in 10 cardiology departments (CD, n=192) and 4 geriatrics departments (GD, n=65) between September 2014 and February 2015. There was no difference in duration of hospital stay (13.1±12.7 vs 11.3±5.6 days, p=0.7). Mean age was different between CD and GD (73.1±15 vs 89.1±5.7 years, p<0.0001) with a greater proportion of women in GD (37% versus 65%, p=0.0006). Comorbidities were more frequent in geriatric population (p=0.0004). Geriatric patients were more often staying in long stay institutions (13% vs 2.7% p<0.0017) or were living alone with medical support (29% vs 16% p<0.02). Cognitive disorders and falls were more prevalent (47% vs 9%, p<0.0001 and 19% vs 3%, p<0.0001 respectively) and there was a trend for more depressions. Infection was a much more frequent trigger (56% vs 16%, p<0.0001) whereas poor compliance was similar in the two subgroups (16%). Patients referred to geriatrics were more likely to be referred by a general practitioner (23% vs 13%, ns) and by emergency departments (76% vs 28% p=0.016) and less likeky to stay in an intensive care unit (13% versus 48%) and to receive nitrates or inotropic support. Fewer patients in geriatrics were discharged home (51% vs 69%, p<0.0001) with more home medical support (43% vs 13% p<0.0001) and more were referred to rehabilitation centers (37% vs 16%, p=0.008).
Patients referred to geriatrics departments for acute heart failure have a different patient journey from those referred to cardiology departments. The high prevalence of cognitive disorders makes management of this condition complex and often requires home medical support.