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Impact of left ventricular ejection fraction phenotypes on healthcare resource utilization in hospitalized heart failure: a secondary analysis of REPORT-HF

Farmakis, Dimitrios (author)
Univ Cyprus, Cyprus
Tromp, Jasper (author)
Natl Heart Ctr Singapore, Singapore; Duke Natl Univ Singapore, Singapore; Univ Med Ctr Groningen, Netherlands; Natl Univ Singapore, Singapore
Marinaki, Smaragdi (author)
Natl & Kapodistrian Univ Athens, Greece
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Ouwerkerk, Wouter (author)
Natl Heart Ctr Singapore, Singapore; Univ Amsterdam, Netherlands
Angermann, Christiane E. E. (author)
Univ Hosp Wurzburg, Germany
Bistola, Vasiliki (author)
Natl & Kapodistrian Univ Athens, Greece
Dahlström, Ulf (author)
Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
Dickstein, Kenneth (author)
Univ Bergen, Norway
Ertl, Georg (author)
Natl Heart Ctr Singapore, Singapore; Univ Amsterdam, Netherlands
Ghadanfar, Mathieu (author)
M Ghadanfar Consulting Life Sci, Switzerland
Hassanein, Mahmoud (author)
Alexandria Univ, Egypt
Obergfell, Achim (author)
Novartis Pharm AG, Switzerland
Perrone, Sergio V. V. (author)
El Cruce Hosp Florencio Varela, Argentina
Polyzogopoulou, Eftihia (author)
Natl & Kapodistrian Univ Athens, Greece
Schweizer, Anja (author)
Novartis Pharm AG, Switzerland
Boletis, Ioannis (author)
Duke Natl Univ Singapore, Singapore
Cleland, John G. F. (author)
Univ Glasgow, Scotland; Imperial Coll, England
Collins, Sean P. P. (author)
Vanderbilt Univ, TN USA
Lam, Carolyn S. P. (author)
Natl Heart Ctr Singapore, Singapore; Duke Natl Univ Singapore, Singapore; Natl Univ Singapore, Singapore
Filippatos, Gerasimos (author)
Natl & Kapodistrian Univ Athens, Greece; Natl & Kapodistrian Univ Athens, Greece
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 (creator_code:org_t)
2023-03-28
2023
English.
In: European Journal of Heart Failure. - : WILEY. - 1388-9842 .- 1879-0844. ; 25:6, s. 818-828
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Aim Evidence on healthcare resource utilization (HCRU) for hospitalized patients with heart failure (HF) and reduced (HFrEF), mildly reduced (HFmrEF) and preserved (HFpEF) ejection fraction is limited.Methods and results We analysed HCRU in relation to left ventricular ejection fraction (LVEF) phenotypes, clinical features and in-hospital and 12-month outcomes in 16 943 patients hospitalized for HF in a worldwide registry. HFrEF was more prevalent (53%) than HFmrEF (17%) or HFpEF (30%). Patients with HFmrEF and HFpEF were older, more often women, with milder symptoms and more comorbidities, but differences were not pronounced. HCRU was high in all three groups; two or more in- and out-of-hospital services were required by 51%, 49% and 52% of patients with HFrEF, HFmrEF and HFpEF, respectively, and intensive care unit by 41%, 41% and 37%, respectively. Hospitalization length was similar (median, 8 days). Discharge prescription of neurohormonal inhibitors was <80% for each agent in HFrEF and only slightly lower in HFmrEF and HFpEF (74% and 67%, respectively, for beta-blockers). Compared to HFrEF, 12-month all-cause and cardiovascular mortality were lower for HFmrEF (adjusted hazard ratios 0.78 [95% confidence interval 0.59-0.71] and 0.80 [0.70-0.92]) and HFpEF (0.64 [0.59-0.87] and 0.63 [0.56-0.71]); 12-month HF hospitalization was also lower for HFpEF and HFmrEF (21% and 20% vs. 25% for HFrEF). In-hospital mortality, 12-month non-cardiovascular mortality and 12-month all-cause hospitalization were similar among groups.Conclusions In patients hospitalized for HF, overall HCRU was similarly high across LVEF spectrum, reflecting the subtle clinical differences among LVEF phenotypes during hospitalization. Discharge prescription of neurohormonal inhibitors was suboptimal in HFrEF and lower but significant in patients with HFpEF and HFmrEF, who had better long-term cardiovascular outcomes than HFrEF, but similar risk for non-cardiovascular events.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Heart failure; Prognosis; Mortality; Heart failure hospitalization; Left ventricular ejection fraction; Pharmacotherapy

Publication and Content Type

ref (subject category)
art (subject category)

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