Background: Despite advances in treatment modalities, systolic heart failure carries a high risk of mortality. Several studies have shown that patients with systolic heart failure also experience frequent hospitalization. Although several medical and surgical intervention studies have examined mortality outcomes in patients with systolic heart failure, an in-depth analysis of outcomes of hospitalized systolic heart failure patients has not been performed. The purpose of this study was to examine outcomes of systolic heart failure patients and resource utilization in systolic heart failure.
Methods: A large administrative database, Vizient database, was used for this retrospective analysis. ICD-10 codes were used to identify adult patients with systolic heart failure. Outcomes and resource utilization variables included mortality, ICU utilization, length of stay and direct costs. Gender, age and racial differences were also examined.
Results: 85,559 patients included in the study had a mean length of stay of 7.12 days and observed mortality of 3.07%. About 1 in 5 patients (20.81%) required ICU care during their hospitalization and mean direct costs for systolic heart failure was noted to be $ 13,209. Interestingly, although mortality was highest in the older age groups (3.93% in >75 years vs 2.22% in 18-50 years), all other variables evaluated were significantly higher in the younger age groups. Length of stay (8.32 ± 14.60 days in 18-50 years vs 5.63 ± 5.51 in >75 years age group; p<0.0001) and ICU utilization (26.40% in 18-50 years vs 13.96% in >75 years age group; p<0.0001) were significantly higher in the younger age groups. Direct costs were more than double in the younger age groups ($18,689 in 18-50 years vs $ 7067 in >75 years; p<0.0001). Men showed significantly higher length of stay (7.30 days in male vs 6.79 days in female), costs ($ 14,226 in male vs $ 11,337 in female; p<0.0001) and ICU admission. Racial disparities in outcomes were also noted. Compared to African-Americans, Caucasians showed significantly worse outcomes with higher length of stay, direct costs ($ 11,009 in African-Americans vs. $ 13,839 in Caucasians; p<0.0001) and ICU admission.
Conclusions: This retrospective analysis of systolic heart failure outcomes found significant gender, race and age disparities. Male group; younger age and Caucasians showed worse outcomes in hospitalized patients with systolic heart failure.