Abstract 283: Outcomes Among Heart Failure Patients Hospitalized For Aortic Dissection: Insight From The National Inpatient Sample

Abstract

Background: Aortic dissection is a significant cause of morbidity and mortality among hospitalized patients. Previous studies suggested that heart failure (HF) is a significant complication of aortic dissection which oftentimes lead to poor outcomes due to delays in diagnosis and overall increase disease burden. However, there is paucity of data regarding the outcomes of hospitalized aortic dissection patients with comorbid HF. Methods: We utilized the National Inpatient Sample (NIS) Database of the years 2018-2020 in conducting a retrospective cohort study. All analyses were done through StataBE 17.0. Our outcomes of interests were risk for in-hospital mortality, acute kidney injury (AKI) and hospital length of stay (LOS) among hospitalized aortic dissection patients with comorbid HF. Results: A total of 149,026 hospitalized aortic dissection patients were identified in our study, of which 10.27% (n= 15,305/149,026) had HF. Among those, 6390 met our inclusion criteria. The overall in-hospital mortality among aortic dissection patients was 4.14% (n=6,170/149,026). Among those with concomitant HF, the mortality rate was significantly higher at 6.37%(n=407/6390) (p=0.00). After adjusting for possible patient and hospital level confounders, concomitant HF among aortic dissection patients was deemed to be an independent predictor of overall in-hospital mortality (aOR 2.21; 95% CI, 1.46-3.36; p=0.00) and it was found that systolic (aOR 2.47; 95% CI, 1.42-4.29; p=0.00) and diastolic HF (aOR 2.11; 95% CI, 1.08-4.13; p=0.03) were associated with higher in-hospital mortality compared to those with combined HF (aOR 1.48; 95% CI, 0.44-4.95; p=0.52). Further, concomitant HF increased the risk for the development of in-hospital AKI (aOR 3.16; 95% CI, 2.35-4.24; p=0.00) and longer LOS (aOR 4.16; 95% CI, 2.92-5.40; p=0.00), regardless of HF subtype. Conclusion: Our analysis showed that comorbid HF increased the risk for in-hospital mortality, risk for AKI and longer hospital LOS. On subgroup analysis, systolic and diastolic HF were associated with increased risk for in-hospital mortality and all three HF subtypes increased the risk for AKI and were associated with a longer hospital LOS.