Examining the Burden of Potentially Avoidable Heart Failure Hospitalizations.

IF 2.1 Q3 HEALTH CARE SCIENCES & SERVICES

ClinicoEconomics and Outcomes Research Pub Date : 2023-09-29 eCollection Date: 2023-01-01 DOI:10.2147/CEOR.S423868

Marya D Zilberberg, Brian H Nathanson, Kate Sulham, John F Mohr, Matthew Goodwin, Andrew F Shorr

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Abstract

Background: Two-thirds of the 1 million annual US CHF hospitalizations are for diuresis only; some may be avoidable. We describe a population of low-severity short-stay (

Methods: We conducted a retrospective cohort study within the Premier Healthcare Database, 2016-2021. CHF was defined via an administrative code algorithm. High severity (CHF-H) was marked by cardiogenic shock, the need for respiratory or circulatory support, and/or a Charlson comorbidity index >2. We compared baseline characteristics, processes of care, and outcomes in low-severity (CHF-L) to CHF-H.

Results: Among 301,672 short-stay CHF patients, 135,304 (44.8%) were CHF-L. Compared to CHF-H, CHF-L was younger (70.5 ± 14.1 vs 72.1 ± 13.6 years, p < 0.001), more commonly female (48.6% vs 45.8%, p < 0.001), and more likely to receive IV ACE-I/ARB agents (0.5% vs 0.4%, p = 0.003). Most other IV medications were more common in CHF-H, and anticoagulation was the most prevalent non-diuretic IV therapy in both groups (23.8% vs 33.3%, p < 0.001). Hospital mortality (0.2% vs 1.5%, p < 0.001) and CHF-related 30-day readmissions (8.1% vs 10.5%, p < 0.001) were lower in CHF-L than CHF-H.

Conclusion: Among short-stay CHF patients, nearly ½ meet criteria for CHF-L, and are mainly admitted for fluid management. Avoiding these admissions could result in substantial savings.

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检查潜在可避免的心力衰竭住院的负担。

背景：每年100万美元CHF住院患者中，三分之二只是因为利尿；有些可能是可以避免的。我们描述了一个低严重程度短期住院的人群（方法：我们在Premier Healthcare数据库中进行了一项回顾性队列研究，2016-2021。CHF是通过管理代码算法定义的。高严重程度（CHF-H）以心源性休克、需要呼吸或循环支持和/或Charlson合并症指数>2为标志。我们比较了低严重程度（CHF-L）和CHF-H的基线特征、护理过程和结果。结果：在301672例短期CHF患者中，135304例（44.8%）为CHF-L。与CHF-H相比，CHF-L更年轻（70.5±14.1 vs 72.1±13.6岁，p＜0.001），更常见的是女性（48.6%vs 45.8%，p＜001），更有可能接受静脉注射ACE-I/ARB药物（0.5%vs 0.4%，p＝0.003）。大多数其他静脉注射药物在CHF-H中更常见，抗凝治疗是两组中最常见的非利尿IV治疗（23.8%vs 33.3%，p＜0.001）。CHF-L的住院死亡率（0.2%vs 1.5%，p＜001）和CHF相关的30天再入院率（8.1%vs 10.5%，p＞0.001）低于CHF-H。避免这些录取可能会带来可观的节省。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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