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Health care utilization and mortality associated with heart failure‐related admissions among cancer patients
AIMS: Heart failure (HF) outcomes continue to improve with widespread use of new therapies. Concurrently, cancer survival has dramatically improved. Yet whether cancer patients share similar strategies and outcomes of inpatient HF treatment to those without HF is unknown. We sought to assess the con...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676288/ https://www.ncbi.nlm.nih.gov/pubmed/31264809 http://dx.doi.org/10.1002/ehf2.12450 |
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author | Guha, Avirup Dey, Amit Kumar Armanious, Merna Dodd, Katherine Bonsu, Janice Jneid, Hani Abraham, William Fradley, Michael G. Addison, Daniel |
author_facet | Guha, Avirup Dey, Amit Kumar Armanious, Merna Dodd, Katherine Bonsu, Janice Jneid, Hani Abraham, William Fradley, Michael G. Addison, Daniel |
author_sort | Guha, Avirup |
collection | PubMed |
description | AIMS: Heart failure (HF) outcomes continue to improve with widespread use of new therapies. Concurrently, cancer survival has dramatically improved. Yet whether cancer patients share similar strategies and outcomes of inpatient HF treatment to those without HF is unknown. We sought to assess the contemporary impacts of cancer on inpatient HF outcomes over time. METHODS AND RESULTS: The retrospective National Inpatient Sample (2003–15) and National Readmissions Database (2013–14) registries were queried for adults admitted for HF and stratified for cancer status, excluding cases of metastatic disease. Temporal trends in HF admissions, hospital charge rates, length of hospitalization, HF‐related procedure utilization, in‐hospital mortality, and hospital readmissions were analysed. Over 13 years of follow‐up, there were 12 769 077 HF admissions (mean age 73 years, 50.8% female, 30.8% non‐White), among which 1 413 287 (11%) had a co‐morbid cancer diagnosis. Cancer patients were older, were predominantly male, and tended to be smokers. Over time, HF admission rates among cancer patients increased, despite a concurrent decrease among patients without cancer (P < 0.0001). After propensity matching, in‐hospital mortality was significantly higher among cancer HF patients (5.1% vs. 2.9%, P < 0.0001). Additionally, HF‐related procedure utilization was disproportionately lower among cancer patients (0.30 vs. 0.35 procedures/HF hospitalization, P < 0.001); the presence of cancer was associated with increased costs, length of hospitalizations, and all‐cause readmissions, but fewer HF readmissions (P < 0.0001, each). CONCLUSIONS: While the incidence of HF hospitalizations has increased among cancer patients, they do not appear to share the same rates of advanced HF care, readmissions trends, or reductions in in‐hospital mortality. Future studies targeting modifiable factors related to these differences are needed. |
format | Online Article Text |
id | pubmed-6676288 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-66762882019-08-06 Health care utilization and mortality associated with heart failure‐related admissions among cancer patients Guha, Avirup Dey, Amit Kumar Armanious, Merna Dodd, Katherine Bonsu, Janice Jneid, Hani Abraham, William Fradley, Michael G. Addison, Daniel ESC Heart Fail Original Research Articles AIMS: Heart failure (HF) outcomes continue to improve with widespread use of new therapies. Concurrently, cancer survival has dramatically improved. Yet whether cancer patients share similar strategies and outcomes of inpatient HF treatment to those without HF is unknown. We sought to assess the contemporary impacts of cancer on inpatient HF outcomes over time. METHODS AND RESULTS: The retrospective National Inpatient Sample (2003–15) and National Readmissions Database (2013–14) registries were queried for adults admitted for HF and stratified for cancer status, excluding cases of metastatic disease. Temporal trends in HF admissions, hospital charge rates, length of hospitalization, HF‐related procedure utilization, in‐hospital mortality, and hospital readmissions were analysed. Over 13 years of follow‐up, there were 12 769 077 HF admissions (mean age 73 years, 50.8% female, 30.8% non‐White), among which 1 413 287 (11%) had a co‐morbid cancer diagnosis. Cancer patients were older, were predominantly male, and tended to be smokers. Over time, HF admission rates among cancer patients increased, despite a concurrent decrease among patients without cancer (P < 0.0001). After propensity matching, in‐hospital mortality was significantly higher among cancer HF patients (5.1% vs. 2.9%, P < 0.0001). Additionally, HF‐related procedure utilization was disproportionately lower among cancer patients (0.30 vs. 0.35 procedures/HF hospitalization, P < 0.001); the presence of cancer was associated with increased costs, length of hospitalizations, and all‐cause readmissions, but fewer HF readmissions (P < 0.0001, each). CONCLUSIONS: While the incidence of HF hospitalizations has increased among cancer patients, they do not appear to share the same rates of advanced HF care, readmissions trends, or reductions in in‐hospital mortality. Future studies targeting modifiable factors related to these differences are needed. John Wiley and Sons Inc. 2019-07-02 /pmc/articles/PMC6676288/ /pubmed/31264809 http://dx.doi.org/10.1002/ehf2.12450 Text en © 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Articles Guha, Avirup Dey, Amit Kumar Armanious, Merna Dodd, Katherine Bonsu, Janice Jneid, Hani Abraham, William Fradley, Michael G. Addison, Daniel Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title | Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title_full | Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title_fullStr | Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title_full_unstemmed | Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title_short | Health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
title_sort | health care utilization and mortality associated with heart failure‐related admissions among cancer patients |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676288/ https://www.ncbi.nlm.nih.gov/pubmed/31264809 http://dx.doi.org/10.1002/ehf2.12450 |
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