Abstract 13644: Hospitalization Outcomes for Patients With Heart Failure With Reduced Ejection Fraction and Iron Deficiency: Analysis of National Inpatient Sample

Abstract

Introduction: Iron deficiency (ID) is associated with worse exercise tolerance in patients with HFrEF regardless of hemoglobin level. Intravenous iron replacement in these patients increases functional capacity, improves quality of life, and reduces recurrent hospitalizations. We examined a large inpatient database to explore the relationship between ID without anemia and outcomes in HFrEF patients. Methods: We queried the National Inpatient Sample (2016-2018) for adults with HFrEF as the principal diagnosis and ID as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes were length of stay, total hospital charges, combined supraventricular and ventricular tachycardia, and cardioversion. STATA software was used for analysis. Multivariate logistic and linear regression analyses were used accordingly to compare groups while adjusting for confounders. Results: Of 446,539 patients hospitalized with HFrEF, 0.16% had concomitant ID without anemia. There was no difference in mortality in HFrEF patients with ID compared to those without ID (2.8% vs 2.9%; aOR 0.97; p=0.94). Length of stay was significantly higher (8.0 vs 5.4 days; CI 0.46-4.5; p=0.02) and there was a non-significant increase in hospital charges ($80,292 vs $57,072; CI -$3,043-$39,821; p=0.09) for HFrEF patients with ID. Tachycardia occurred more frequently in HFrEF patients with ID (18.8% vs 10.3%; aOR 1.93; p=0.004), but there was no significant difference in cardioversion (1.39% vs 1.68%; aOR 0.82; p=0.78). Conclusions: We did not find an association between ID and inpatient mortality in HFrEF patients. Symptomatic improvement is an important factor for determining time of discharge in patients admitted for HFrEF and our analysis demonstrates significantly longer hospitalization in patients with ID. Further studies may elaborate on the effect of iron replacement on duration of hospitalization for patients admitted with HFrEF.