Abstract 16794: Characteristics, Trends, Outcomes, and Costs of Stimulant-Related Acute Heart Failure Hospitalizations in the United States

Abstract

Introduction: Heart failure hospitalizations remains significant burden on the health care system. Simulants including cocaine and methamphetamine are amongst the most used illegal substances in the United States. The information regarding stimulant related heart failure hospitalizations is scarce. Hypothesis: We sought to evaluate the characteristics and trends of stimulants-related heart failure hospitalizations in the United States and their associated outcomes and resource utilization. Methods: Using the National Inpatient Sample (NIS), we identified patients with a primary diagnosis of heart failure hospitalization. These hospitalizations were further divided into those with and without a concomitant diagnosis of stimulant (cocaine or amphetamine) dependence or abuse. Survey specific techniques were employed to compare trends in baseline characteristics, complications, procedures, outcomes and resource utilization between the two cohorts. Results: We identified 9,932,753 hospitalizations (weighted) with a primary diagnosis of heart failure, of those 138,438 (1.39%) had a diagnosis of active stimulant use. The proportion of stimulant related ACHF hospitalization is on the rise (1.1% to 1.9%) as the mean age of these stimulant related ACHF hospitalizations (from 49.9 to 52 years). Stimulant related ACHF hospitalization mostly affects African Americans and the proportion of ACHF is highest amongst the age group of 30-39 years. It is associated with increased incidence of in-hospital complications but lower mortality and length of stay. These patients have more than 7-fold higher discharge against medical advice. Conclusions: Stimulant related heart failure hospitalizations have been increasing. Evaluation of in-hospital outcomes is limited by a high proportion of patients leaving against medical advice.