P1477Impact of cardiovascular risk factors and disease on length of stay and mortality in patients with heart failure

H. Khawar, P.R. Carter, N.D. Gollop, H. Uppal, S. Chandran, R. Potluri
2017 European Heart Journal  
Results: During the subsequent follow up of 2,453,227 person-years, 417,430 patients had mortality from HF discharge, which was estimated to be 17.02 per 100 person-years. Markedly graded reduction of incident death rate across Low, Median and High income level groups (23.11, 10.08 and 6.92 per 100 personyears, p for trend: <0.001) was observed, with higher income individuals showed significantly lower all cause mortality risk (HR: 0.58 [95% CI: 0.57-0.58]; 0.51 [95% CI: 0.50-0.52], log rank
more » ... .001), Low income as reference) after controlling for age, gender and baseline medical co-morbidities ( Figure 1 ). Conclusions: Lower income almost doubled the risk of death rate from HF postdischarge compared to high income individuals despite nationwide coverage of healthcare delivery, possibly due to unknown barriers or biased resource redistribution. These data may raise public health awareness to circumvent impact of income inequality in managing HF. Background and purpose: Heart failure affects over 900,000 people in the United Kingdom (UK) and costs nearly 2% of the National Health Service (NHS) budget. Traditional risk factors for heart failure have been thoroughly investigated, however the impact of cardiovascular risk factors/disease on length of stay (LOS) and mortality in heart failure patients has not previously been studied, which was the aim of the present study. Methods: We studied patients admitted to seven hospitals across the UK between 2000-2013 using the Algorithm for Comorbidities, Associations, Length of Stay and Mortality (ACALM) study protocol. Data on demographics, LOS, cardiovascular comorbidities and mortality was available for all patients. Results: See table below. Of 31,760 adults with heart failure, mean LOS was 11.6 (SD 20.7) days and there were 21,090 (66.4%) deaths in total. Hypertension, hyperlipidaemia and angina were associated with reduced LOS and mortality. Chronic kidney disease, peripheral vascular disease and ischaemic stroke were associated with longer LOS and greater mortality. Type 2 diabetes was associated with longer LOS, whereas type 1 diabetes and myocardial infarction were associated with greater mortality. Conclusions: Cardiovascular risk factors and disease have a significant but varying impact on length of stay and mortality in heart failure patients. These factors should be utilised to stratify heart failure patients.
doi:10.1093/eurheartj/ehx502.p1477 fatcat:q5lip3epxfhmfp7jhuofixd2zy