While depressed left ventricular ejection fraction is clearly associated with poor long-term outcome in heart failure (HF), the effect of ejection fraction on short-term outcomes and resource utilization following hospitalization for HF remains unclear.
Hypothesis : We evaluated the independent effect of depressed ejection fraction (<=40%) on short-term outcomes and resource utilization following hospitalization for HF.
The study population included 443 consecutive patients hospitalized for DRG 127 (HF and shock) with known ejection fraction.
For each patient, we assessed the hospitalization cost (1995 US$), length of stay, in-hospital mortality, 30-day mortality, and 30-day readmission rates.
Despite similar disease severity at admission, patients with ejection fraction <= 40% (Group I) had longer length of stay (4.0 vs. 3.7 days ; p=0.03), a tendency toward higher hospitalization cost ($3,054 vs. $2,770 ; p=0.08), more readmissions for any cause (0.4 vs. 0.3 ; p=0.05) and for HF (0.2 vs. 0.1 ; p=0.01), but similar in-hospital (2.5 vs. 2.6%) and 30-day mortality (4.0 vs. 4.6%) compared with patients with ejection fraction>40% (Group 2).
In multivariate analyses, Group I patients were more likely to have higher than median hospitalization cost [odds ratio (OR)=1.98 ; 95% confidence intervals (CI)=1.02-3.91] and longer than median hospital stay (OR=1.68 ; CI=1.08-3.91) ; they were also more likely to be readmitted for any cause (OR=2. (...)
Mots-clés Pascal : Insuffisance cardiaque, Homme, Fraction éjection, Ventricule gauche, Pronostic, Court terme, Hospitalisation, Traitement, Coût, Economie santé, Appareil circulatoire pathologie, Cardiopathie
Mots-clés Pascal anglais : Heart failure, Human, Ejection fraction, Left ventricle, Prognosis, Short term, Hospitalization, Treatment, Costs, Health economy, Cardiovascular disease, Heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0191185
Code Inist : 002B12A01. Création : 16/11/1999.