Construction of a Heart Failure Database Collating Administrative Claims Data and Electronic Medical Record Data to Evaluate Risk Factors for In-Hospital Death and Prolonged Hospitalization

Background: Clinical studies on heart failure (HF) using diagnosis procedure combination (DPC) databases have attracted attention recently, but data obtained from such databases may lack important information essential for determining the severity of HF. Methods and Results: Using a HF database that collates DPC data and electronic medical records from 3 hospitals in Japan, we investigated factors contributing to prolonged hospitalization and in-hospital death, based on clinical characteristics and data obtained early during hospitalization in 2,750 Japanese patients with HF hospitalized between 2011 and 2015. Mean age was 77.0±13.0 years; 55.3% (n=1,520) were men, and 39.1% (n=759) had left ventricular ejection fraction <40%. In-hospital mortality was 6.0% (n=164) and mean length of stay for patients who were discharged alive was 18.2±13.7 days (median, 15 days). Factors contributing to in-hospital death were advanced age, higher New York Heart Association (NYHA) class, low albumin and sodium, and high creatinine and C-reactive protein (CRP). Factors contributing to prolonged hospitalization were higher NYHA class, low Barthel index, low albumin, and high B-type natriuretic peptide, lactate dehydrogenase, and CRP. Conclusions: We have constructed a database of HF hospitalized patients in acute care hospitals in Japan. This approach may be helpful to address clinical parameters of HF patients in any acute care hospital in Japan.