Predictors and Associations With Outcomes of Length of Hospital Stay in Patients With Acute Heart Failure: Results From VERITAS

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• 作者：Gad Cotter ; MD¹ ; ^{gadcotter@momentum-research.com" class="auth_mail" title="E-mail the corresponding author} ; Beth A. Davison ; PhD¹ ; Olga Milo ; MD¹ ; Robert C. Bourge ; MD² ; John G.F. Cleland ; MD³ ; ⁴ ; Guillaume Jondeau ; MD⁵ ; Henry Krum ; MD⁶ ; ^&dagger ; ; Christopher M. O'Connor ; MD⁷ ; Marco Metra ; MD⁸ ; John D. Parker ; MD⁹ ; Guillermo Torre-Amione ; MD ; PhD¹⁰ ; Dirk J. van Veldhuisen ; MD¹¹ ; Isaac Kobrin ; MD¹² ; Maurizio Rainisio ; PhD¹³ ; Stefanie Senger ; PhD¹ ; Christopher Edwards ; BS¹ ; John J.V. McMurray ; MD¹⁴ ; John R. Teerlink ; MD¹⁵ ; for the VERITAS Investigators
• 关键词：Heart failure ; length of stay ; prognosis
• 刊名：Journal of Cardiac Failure
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：22
• 期：10
• 页码：815-822
• 全文大小：321 K

文摘

The length of hospital stay (LOS) is important in patients admitted for acute heart failure (AHF) because it prolongs an unpleasant experience for the patients and adds substantially to health care costs.

Methods and Results

We examined the association between LOS and baseline characteristics, 10-day post-discharge HF readmission, and 90-day post-discharge mortality in 1347 patients with AHF enrolled in the VERITAS program. Longer LOS was associated with greater HF severity and disease burden at baseline; however, most of the variability of LOS could not be explained by these factors. LOS was associated with a higher HF risk of both HF readmission (odds ratio for 1-day increase: 1.08; 95% confidence interval [CI] 1.01–1.16; P = .019) and 90-day mortality (hazard ratio for 1-day increase: 1.05; 95% CI 1.02–1.07; P < .001), although these associations are partially explained by concurrent end-organ damage and worsening heart failure during the first days of admission.

Conclusions

In patients who have been admitted for AHF, longer length of hospital stay is associated with a higher rate of short-term mortality.

Clinical Trial Registration

VERITAS-1 and -2: Clinicaltrials.gov identifiers NCT00525707 and NCT00524433.