Heart Failure World: Risk factors for heart failure mortality in hospitalized patients

Abstract

Introduction: Heart failure is a growing public health problem with an estimated prevalence of 4-5 million American population. Despite significant advances in heart failure management, the mortality remains high. This study aspires to investigate the risk factors that are associated with mortality in hospitalized heart failure patients. Methods: We utilized the 2019 National Inpatient Sample (NIS) dataset sponsored by the Agency for Healthcare Research and Quality (AHRQ) under the Healthcare Cost and Utilization Project (HCUP). Patients with Heart Failure (HF) were identified using Clinical Classifications Software Refined (CCSR) for International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Variable of interest include hypertension, diabetes, dyslipidemia, peripheral vascular disease, nicotine use and sleep apnea. Clinical outcomes include HF hospitalizations and effect of different variable on HF mortality. Results: A weighted total of 5,675,784 HF related hospitalizations were recorded in the year 2019. A total of 3907455(68.9%) had hypertension, 2080710(36%) had diabetes and 3081445 (54%) had dyslipidemia . 651035(11%) had a comorbidity of peripheral arterial disease, 1542990 (27.1%) were nicotine dependent, and 991150 (17.4%) had sleep apnea. The mortality rate per 10,000 HF hospitalizations were analyzed. There were 7047 deaths due to hypertension as compared to 2953 in non-hypertensive population, 2368 deaths due to diabetes as compared to 2122 deaths in patients without diabetes. The Mortality rate was 4502 in patients with dyslipidemia as compared to 4234 in patients without dyslipidemia. Peripheral arterial disease (PAD) lead to 2434 death as compared to 2183 death in patients without PAD. The mortality rate 4649 deaths due to nicotine use as compared to 4278 in patients who do not use nicotine and 4580 was due to sleep apnea as compared to 4336 death in patients with no sleep apnea. Conclusion: Heart failure lead to significant number of hospitalization in the United States in year 2019. Among all studied factors, hypertension was found to be associated with highest mortality risk. This study guides the importance of strict blood pressure control in significantly decreasing mortality associated with heart failure.