Author + information
- Alejandro Lemor,
- Shawn Lee,
- Carlos Gongora,
- Abel Casso Dominguez and
- Davendra Mehta
Background: Chronic kidney disease (CKD) is an important global health problem and is associated with significant cost, morbidity and mortality; previous studies have associated CKD and cardiovascular diseases with worse outcomes. We aim to determine if End-Stage Renal Disease (ESRD) has a significant impact in clinical outcomes in patients with Congestive Heart Failure (CHF).
Methods: This is a retrospective cohort study using the 2013 National Inpatient Sample (NIS) of adult patients hospitalized with systolic or diastolic CHF as the admitting diagnosis. The primary outcome was in-hospital mortality; secondary outcomes included mean length of hospital stay, ICU admission, shock, acute respiratory failure, and mean total hospital charges. We adjust our results for age, gender, Charlson Comorbidity Index and hospital bed size.
Results: A total of 324,965 patients with CHF were identified in our sample population, out of which 14,805 had ESRD. We found that patients with ESRD admitted with systolic CHF had 86% more probability of inpatient mortality than those without ESRD (OR: 1.86; p<0.00); Likewise, patients with diastolic CHF and ESRD had 49% more chance of inpatient mortality (OR: 1.49; p<0.00). Similarly, for the secondary outcomes; patient with systolic CHF and ESRD had significantly higher rates of ICU admissions (OR: 1.54, p<0.00), mean length of stay (+1.5 days, p<0.00), mean hospital charges (+ US$ 17,665, p<0.00), and acute respiratory failure (OR: 1.53, p<0.00). Patients admitted with diastolic CHF and ESRD also had significantly higher rates of ICU admissions (OR: 1.75, p<0.00), mean length of stay (+0.9 days, p<0.00), mean hospital charges (+ US$ 17,905, p<0.00), shock (OR: 1.71, p<0.00).and acute respiratory failure (OR: 1.49, p<0.00).
Conclusions: ESRD significantly increases the chance of inpatient mortality for patients admitted with systolic and diastolic CHF. Their risk for ICU admissions, shock and acute respiratory failure is higher than in patients without ESRD. Hospital costs and length of stay are also higher for patients with ESRD. This group of patients represent a high-risk group for which careful clinical management is recommended.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-274
- 2017 American College of Cardiology Foundation