Abstract 9992: Homelessness and Heart Failure

Abstract

Background: Homelessness is an important social determinant of health. Since heart failure (HF) contributes to significant morbidity and mortality, we sought to investigate the association of homelessness with clinical outcomes in the patients hospitalized with HF. Methods: We analyzed the National Inpatient Sample (NIS) database between 2016 and 2018. Primary HF hospitalizations and homeless adults were identified through ICD codes. Multivariable adjusted logistic regression was used to assess the association of homelessness and clinical outcomes. Results: Of 3522459 weighted primary HF hospitalizations identified, only minority of patients were identified as homeless (n=28555; 0.81%). Homeless adults were younger (mean age: 56 vs. 72 years) and had lower prevalence of clinical comorbidities (diabetes, hypertension, obesity, dyslipidemia, renal failure, peripheral vascular disease, stroke) compared with non-homeless adults. However, homeless adults had higher prevalence of drug, tobacco, and alcohol abuse than non-homeless adults. Adjusted models showed lower odds of inpatient mortality and clinical complications among homeless adults. Conclusion: Homeless adults were younger and had higher prevalence of drug abuse, but lower burden of clinical comorbidities than non-homeless adults. While homeless adults had lower inpatient mortality and clinical complications, the interpretation of these results is limited by lower hospitalization rates among homeless. Majority of homeless adults may not seek medical attention due to poor social support. .