Farmakis, D. et al. (2023) Impact of left ventricular ejection fraction phenotypes on healthcare-resource utilization in hospitalized heart failure: a secondary analysis of REPORT-HF. European Journal of Heart Failure, 25(6), pp. 818-828. (doi: 10.1002/ejhf.2833) (PMID:36974770)
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Abstract
Background: Evidence on healthcare resource utilization (HCRU) for hospitalized patients with heart failure (HF) and reduced (HFrEF), mildly-reduced (HFmrEF) and preserved (HFpEF) left ventricular ejection fraction (LVEF) is limited. Methods: We analysed HCRU in relation to LVEF phenotypes, clinical features and in-hospital and 12-month outcomes in 16,943 patients hospitalized for HF in a worldwide registry. Results: 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; 2 or more in- and out-hospital services were required by 51%, 49% and 52% of patients with HFrEF, HFmrEF and HFpEF, respectively, and ICU 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, 0.76 (0.68-0.84) and 0.77 (0.68-0.88)] and HFpEF [0.62 (0.56-0.68) and 0.60 (0.53-0.68)]; 12-month HF hospitalization was also lower for HFpEF and HFmrEF (21% and 20% versus 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 were 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.
| Item Type: | Articles |
|---|---|
| Additional Information: | This study was funded by Novartis Pharma AG. |
| Keywords: | heart failure, prognosis, mortality, heart failure hospitalization, left ventricular ejection fraction, pharmacotherapy. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Cleland, Professor John |
| Authors: | Farmakis, D., Tromp, J., Marinaki, S., Ouwerkerk, W., Angermann, C. E., Bistola, V., Dahlstrom, U., Dickstein, K., Ertl, G., Ghadanfar, M., Hassanein, M., Obergfell, A., Perrone, S. V., Polyzogopoulou, E., Schweizer, A., Boletis, I., Cleland, J. G.F., Collins, S. P., Lam, C. S.P., and FIlippatos, G. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | European Journal of Heart Failure |
| Publisher: | Wiley |
| ISSN: | 1388-9842 |
| ISSN (Online): | 1879-0844 |
| Published Online: | 28 March 2023 |
| Copyright Holders: | Copyright © 2023 European Society of Cardiology |
| First Published: | First published in European Journal of Heart Failure 25(6):818-828 |
| Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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