Background: Diastolic heart failure is an increasingly prevalent condition and has been shown in studies to be a prognostic indicator of future morbidity and all-cause mortality. Several interventions and novel therapeutic modalities have shown benefit in patients with diastolic heart failure with respect to improved mortality. Despite these studies, a comprehensive evaluation of outcomes and resource utilization in patients with diastolic heart failure is lacking. The aim of this study was to examine outcomes of patients hospitalized with diastolic heart failure.
Methods: This is a retrospective observational study of inpatient hospitalization of patients with diastolic heart failure using national administrative database, the Vizient database. All adult patients admitted with a principal diagnosis of diastolic heart failure between 2015-2017 were included in the study using ICD-10 codes. Outcome variables analyzed include mortality, length of stay, direct costs and ICU utilization. Age, gender and racial differences in outcomes was also analyzed. Appropriate statistical tests were used for analysis.
Results: 69,410 patients admitted during the study period were included in the study. Mean length of stay in these patients is 5.68 days with 12.30% requiring ICU care during their hospitalization. Younger age group is shown to have poor outcomes except mortality which is highest in the older age group (1.12% in 18-50 years vs 2.78% in >75 years; p<0.0001). ICU admission was higher in 18-50 years age group (15.27% in 18-50 years vs 10.23% in >75 years; p<0.0001). Costs were significantly higher in the younger age group ($ 8273 ± 20,811 in 18-50 years vs $ 5589 ± 6451 in >75 years; p<0.0001). No significant difference in outcomes and resource utilization was noted with respect to gender. African-Americans showed significantly worse outcomes compared to Caucasians. Significantly higher length of stay (5.98 ± 8.13 days in African-Americans vs 5.57 ± 5.30 days in Caucasians; p<0.0001), ICU utilization (13.86% in African-Americans vs 11.82% in Caucasians; p<0.0001) and costs were found in African-Americans compared to Caucasians.
Conclusions: This retrospective analysis of outcomes in patients with diastolic heart failure showed age and racial disparities. Younger age group showed poor outcomes and higher resource utilization except mortality. No gender differences in outcomes was noted in the study. African-Americans showed poor outcomes compared to Caucasians in the study.