scholarly journals Worsening Blood Urea Nitrogen and Creatinine levels Can Predict Length of Hospital Stay and 30-day Readmission Rate Among Patients with Heart Failure and Reduced Ejection Fraction Admitted for Acute Heart Failure Syndrome

2017 ◽  
Vol 23 (8) ◽  
pp. S81-S82
Author(s):  
Fadi Ghrair ◽  
Priya Bansal ◽  
Darshan Patel ◽  
Hassan Alkhawam ◽  
Thomas Marino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Hospital Stay ◽  
Acute Heart Failure ◽  
Blood Urea Nitrogen ◽  
Readmission Rate ◽  
Length Of Hospital Stay ◽  
Reduced Ejection Fraction ◽  
Acute Heart Failure Syndrome ◽  
Patients With Heart Failure

scholarly journals Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction

2019 ◽  
Vol 5 (2) ◽  
pp. 59-65
Author(s):  
Yoriyasu Suzuki ◽  
Akira Murata ◽  
Satoshi Tsujimoto ◽  
Yusuke Ochiumi ◽  
Tatsuya Ito
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Rest Period ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure

Abstract Background: There is no known therapy with proven efficacy for improving clinical outcomes in elderly patients with heart failure (HF) and preserved ejection fraction (HFpEF). In this study, we aimed to evaluate the efficacy of tolvaptan (TLV) in elderly HFpEF patients. Methods: This retrospective observational study involved 100 consecutive elderly HFpEF patients hospitalized at the Nagoya Heart Center, Japan. Inclusion criteria were: (1) patients aged ≥75 years; (2) first hospitalization secondary to HF; (3) received medical therapy for HF, without invasive treatment; and (4) clinical follow-up for >6 months after discharge. The primary endpoint was rehospitalization due to worsening HF, and the secondary endpoint was worsening renal function (WRF) during hospitalization and at 6 months after discharge. Sixty background-matched HFpEF patients were divided into 2 groups: with TLV therapy (TLV (+), n = 29) and without TLV therapy (TLV (–), n = 31). In the TLV (+) group, TLV therapy was continued after discharge. Clinical outcomes of these patients were evaluated. Results: Bed rest period and length of hospital stay were significantly shorter in the TLV (+) group than in the TLV (−) group. The dose of loop diuretics, mean serum creatinine levels, and incidence of WRF development were significantly lower in the TLV (+) group. Incidence of rehospitalization was also significantly lower in the TLV (+) group (log-rank test; p = 0.018). The multivariate logistic regression analysis demonstrated that TLV therapy reduces the incidence of rehospitalization in elderly patients with HFpEF. Conclusions: TLV therapy reduced the bed rest period, length of hospital stay, and rate of rehospitalization without WRF in elderly HFpEF patients, suggesting that TLV could represent an effective therapy for this group of patients.

scholarly journals Diabetes in Patients With Heart Failure With Reduced Ejection Fraction During Hospitalization: A Retrospective Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yiling Zhou ◽  
Miye Wang ◽  
Si Wang ◽  
Nan Li ◽  
Shengzhao Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Cardiogenic Shock ◽  
Hospital Stay ◽  
Reduced Ejection Fraction ◽  
Icu Admission ◽  
Patients With Heart Failure ◽  
Patients With Diabetes ◽  
Subgroup Effects

BackgroundDiabetes is prevalent worldwide including hospitalized patients with heart failure with reduced ejection fraction (HFrEF). This retrospective study investigated the association of diabetes with in-hospital adverse events in patients with HFrEF.MethodsWe analyzed data from electronic medical records of patients hospitalized with HFrEF in West China Hospital of Sichuan University from January 1, 2011, to September 30, 2018. Propensity score matching balances the baseline characteristics between patients with and without diabetes. Logistic and Poisson regressions investigated the association of diabetes with risks of intubation, cardiogenic shock, acute kidney injury (AKI), intensive care unit (ICU) admission and death during hospitalization, and length of ICU and hospital stay in the matched cases.ResultsAmong 6,022 eligible patients (including 1,998 with diabetes), 1,930 patient pairs with and without diabetes were included by propensity score matching. Patients with diabetes had a significantly increased risk of intubation (odds ratio [OR], 2.69; 95% confidence interval [CI], 2.25–3.22; P<0.001), cardiogenic shock (OR, 2.01; 95% CI, 1.72–2.35; P<0.001), AKI at any stage (OR, 1.67; 95% CI, 1.44–1.94; P<0.001), ICU admission (OR, 1.89; 95% CI, 1.65–2.15; P<0.001), and death (OR, 4.25; 95% CI, 3.06–6.02; P<0.001) during hospitalization. Patients with diabetes had longer ICU (median difference, 1.47 days; 95% CI, 0.96–2.08; P<0.001) and hospital stay (2.20 days; 95% CI, 1.43–2.86; P<0.001) than those without diabetes. There were potential subgroup effects by age and by hypertension, and CKD status on the association of diabetes with risk of AKI at any stage; and subgroup effects by sex and CKD status on the association of diabetes with risk of intubation. The increase in length of hospital stay was larger in patients without hypertension than those with hypertension.ConclusionsAmong patients with HFrEF, those with diabetes have a worse prognosis, including a higher risk of in-hospital intubation, cardiogenic shock, AKI, ICU admission and death during hospitalization, and longer ICU and hospital stay.

ID: 14: DIGITALIS INCREASES THE 30-DAY READMISSION RATE IN PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION

2016 ◽  
Vol 64 (4) ◽  
pp. 924.1-924
Author(s):  
H Alkhawam ◽  
J Sall ◽  
JJ Lieber ◽  
TJ Vittorio
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Ejection Fraction ◽  
Readmission Rate ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Treatment Groups ◽  
Patients With Heart Failure

IntroductionDigitalis has been used for over 200 years to treat patients with heart failure (HF). Evidence from clinical trials supports the use of digitalis in patients with HF due to left ventricular (LV) systolic dysfunction, particularly in patients with more advanced symptoms. However, there is no evidence that digitalis improves survival.HypothesisWe evaluated the role of digitalis use in the 30-day readmission rate, mortality rate and length of stay (LOS) in patients with heart failure and reduced ejection fraction (HFrEF).MethodsWe performed a retrospective chart analysis of 1,616 patients who were admitted to the hospital from 2005 to 2012 due to decompensated HF. 781 patients had HFrEF. The medications of all 781 patients with HFrEF were reviewed. The HFrEF patients were divided into two groups: digitalis-treated and non-digitalis treated. The 30-day readmission rate, mortality rate and LOS were subsequently determined.ResultsOf the 781 patients with HFrEF, 196 (25%) did receive digitalis treatment versus 584 (75%) did not receive Digitalis treatment. After the other medications in each group were standardized, the digitalis-treatment HFrEF group had a higher 30-day readmission rate compared to the non-digitalis treatment HFrEF group (OR: 1.5, 95% CI: 1.1–2.2, p=0.04). The morality rate and LOS between the digitalis-treatment and non-digitalis treatment groups did not differ (p=0.7 and 0.4, respectively).ConclusionOur study confirmed that digitalis use in HFrEF does not improve the survival rate and length of stay. However, our study showed that digitalis use can increase the 30-day readmission rate.

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