National Trends in Incidence and Outcomes of Patients With Heart Failure Requiring Respiratory Support
Section snippets
Methods
We obtained data from 2002 through 2014 from the NIS database, which was developed by the Healthcare Cost and Utilization Project (HCUP).6 As previously described, the NIS is the largest, publicly available all-payer inpatient database in the United States. It includes a 20% stratified sample of inpatient hospitalizations (excluding observation status and psychiatric hospitals) as well as all procedural and International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
Results
From 2002 to 2014, we identified 9,508,768 hospitalizations with a primary diagnosis of HF, which included 202,340 (2.13%) and 257,549 (2.71%) hospitalizations that required either IMV or NIV, respectively (Table 1). Compared with a mean (Ā±SE) age of 72.0 (Ā±0.1) years for those not requiring respiratory support, recipients of IMV and NIV were younger with a mean age of 70.0 (Ā±0.1) and 70.9 (Ā±0.1) years (p <0.0001 for both). Recipients of IMV and NIV were more likely to be black or Hispanic and
Discussion
In this national study of patients hospitalized with HF from 2002 through 2014, we found that nearly 5% of HF hospitalizations required the use of respiratory support. Over the study period, there was a significant change in ventilator strategy utilization with an increase in NIV and decrease in IMV. Among those requiring IMV, the in-hospital mortality was nearly 40%. Mortality among NIV recipients improved whereas cost increased significantly for both types of respiratory support. These
Disclosures
The authors have no conflicts of interest to disclose.
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Funding: None.
- 1
These authors contributed equally to this work.