Epidemiological Trends of Heart Failure Subtypes, Characteristics, and Outcomes Within Inpatient Hospitalizations

Abstract

Background: This secondary analysis of a cross-sectional observational study aimed to evaluate the impact of heart failure (HF) classification on inpatient outcomes and demographic associations.

Methods: Data from the 2019 National Inpatient Sample (NIS) included 259,025 patients older than 18 years with a primary International Classification of Diseases, 10th Revision (ICD-10) diagnosis of HF.

Results: Weighted results for this study showed that HF subtypes were stratified as diastolic (35.63%, n = 92,300), systolic (30.09%, n = 77,931), combined systolic-diastolic (18.74%, n = 48,529), other (11.81%, n = 30,593), end-stage (1.56%, n = 4,030), right (1.18%, n = 3,063), and biventricular (1.00%, n = 2,579). Acuity was categorized as acute on chronic HF (72.68%, n = 188,106), acute HF (10.79%, n = 27,948), chronic HF (1.84%, n = 4,778), and indeterminate (15%, n = 38,193). Demographically, older adults (≥ 75 years), African Americans, and males were found to be more frequently admitted, with age being the most significant factor. Younger patients (< 75 years) were more often diagnosed with non-diastolic HF, while minority groups had higher incidences of systolic and combined HF. Females were more likely to have diastolic HF compared to males. Right, biventricular, and end-stage HF were associated with increased inpatient costs, longer hospital stays, and higher mortality rates. Detailed HF classification reveals significant variations in inpatient outcomes and demographic associations.

Conclusions: Advanced HF subtypes incur higher costs, longer hospital stays, and increased mortality, underscoring the need for improved classification and earlier intervention across diverse populations. Further research is needed to refine HF diagnosis and coding to better understand and manage these conditions.