Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
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Original Article

Volume 16, Number 6, December 2025, pages 479-488


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

Figure

Figure 1.
Figure 1. Percentages of heart failure (HF) hospitalizations across age group, race/ethnicity, and sex. This sample-weighted national estimation illustrates the percentages of patients hospitalized with a primary diagnosis of heart failure stratified by age groups, race/ethnicity, and sex. Error bars and value in parentheses represent 95% confidence intervals (CIs). HF: heart failure; API: Asian-American and Pacific Islander.

Tables

Table 1. Comparisons Between Hospitalizations With and Without a Primary Diagnosis of HF
 
Demographics domainNon-HF hospitalizationHF hospitalizationP value
Sample size (105)Weighted estimation (106)% of inpatientsSample size (105)Weighted estimation (106)% of inpatients
The weighted estimation has been represented as n (95% confidence interval). The term “sample size” refers to the number of inpatients included in the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). Statistical significance was determined to be at P < 0.05, and the P value was determined from the Rao-Scott Chi-square test for the sample-weighted national estimations. HF: heart failure; AA: African American, API: Asian-American and Pacific Islander.
Overall57.8528.92 (27.87 - 29.98)95.702.591.30 (1.25 - 1.34)4.30< 0.0001
Race/ethnicity
  White38.0519.02 (18.28 - 19.76)95.831.660.83 (0.80 - 0.86)4.17< 0.0001
  AA8.494.24 (3.99 - 4.50)93.910.550.28 (0.26 - 0.29)6.09
  Hispanic6.323.16 (2.94 - 3.38)96.790.210.10 (0.10 - 0.11)3.21
  API1.600.80 (0.73 - 0.87)96.570.060.03 (0.02 - 0.03)3.43
  Other racial/ethnic background3.401.70 (1.56 - 1.84)96.650.120.06 (0.05 - 0.06)3.35
Sex
  Male24.6012.30 (11.83 - 12.76)94.761.360.68 (0.65 - 0.71)5.24<0.0001
  Female33.2416.62 (16.02 - 17.22)96.431.230.62 (0.59 - 0.64)3.57
Age group
  18 - 3410.985.49 (5.27 - 5.72)99.690.030.02 (0.02 - 0.02)0.31< 0.0001
  35 - 5411.885.94 (5.70 - 6.18)97.520.300.15 (0.14 - 0.16)2.48
  55 - 7421.0310.51 (10.11 - 10.91)95.271.040.52 (0.50 - 0.54)4.73
  ≥ 7513.966.98 (6.73 - 7.23)92.011.210.61 (0.58 - 0.63)7.99

 

Table 2. Risk Assessment of HF Encounters for the General Population Estimated by the 2019 US Census
 
VariablesRelative risk (RR)95% CI of RRP value
The data were represented as relative risk with 95% CI. Statistical significance was determined to be at P < 0.05, and P value was tested by a Poison regression. HF: heart failure; CI: confidence interval; RR: rate ratio.
Race/ethnicity
  White (reference)1.00
  African American2.492.06 - 2.98< 0.0001
  Hispanic American0.880.66 - 1.150.38
  Asian American and Pacific Islander0.500.29 - 0.800.01
  Other racial/ethnic background3.482.39 - 4.87< 0.0001
Sex
  Female (reference)1.00
  Male1.381.19 - 1.590.0002
Age group
  ≥ 75 (reference)1.00
  55 - 740.250.21 - 0.29< 0.0001
  35 - 540.060.05 - 0.08< 0.0001
  18 - 340.010.00 - 0.01< 0.0001

 

Table 3. National Estimation of HF Inpatients Classified by Type and Acuity With Corresponding Hospital Outcomes
 
HF definitionsSample sizeWeighted estimation (103)Hospital outcomes
Presentative size (95% CI)Percent (%)Length of stay (days)Total charge ($103)In-hospital mortality (%)
The weighted estimates are presented as n with a 95% CI. The term “sample size” refers to the number of inpatients included in the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). HF: heart failure; CI: confidence interval.
Types of HF defined by affected organ location and function
  Systolic HF77,931389.66 (374.70 - 404.61)30.095.16 (5.09 - 5.24)59.25 (57.06 - 61.44)2.27 (2.20 - 2.40)
  Diastolic HF92,300461.50 (444.97 - 478.03)35.635.17 (5.13 - 5.21)47.84 (46.72 - 48.96)1.89 (1.80 - 2.00)
  Combined systolic-diastolic HF48,529242.65 (231.53 - 253.76)18.745.95 (5.85 - 6.05)63.79 (60.32 - 67.25)2.68 (2.50 - 2.80)
  Right HF3,06315.32 (14.40 - 16.23)1.186.49 (6.24 - 6.73)63.65 (58.70 - 68.61)3.56 (2.90 - 4.60)
  Biventricular HF2,57912.90 (11.82 - 13.97)1.007.63 (7.29 - 7.96)85.55 (75.34 - 95.75)4.46 (3.60 - 5.30)
  End-stage HF4,03020.15 (18.03 - 22.27)1.5610.77 (10.14 - 11.40)174.29 (154.76 - 193.81)10.33 (9.30 - 11.40)
  Other30,593152.97 (147.03 - 158.90)11.815.34 (5.23 - 5.44)60.49 (58.44 - 62.54)3.30 (3.10 - 3.50)
HF defined and specified by phenotypes of acuity
  Acute27,948139.74 (134.74 - 144.74)10.794.62 (4.56 - 4.67)51.73 (50.33 - 53.12)1.53 (1.38 - 1.68)
  Acute on chronic188,106940.53 (905.79 - 975.27)72.685.57 (5.51 - 5.64)57.85 (55.83 - 59.87)2.41 (2.33 - 2.49)
  Chronic4,77823.89 (22.66 - 25.12)1.844.96 (4.72 - 5.19)61.64 (57.45 - 65.83)2.83 (2.17 - 3.48)
  Undefined or unspecified38,193190.97 (183.64 - 198.29)14.695.58 (5.47 - 5.70)64.83 (62.05 - 67.60)3.57 (3.34 - 3.79)
  Total259,0251,295.13 (1,249.1 - 1,341)1005.46 (5.40 - 5.52)58.28 (56.35 - 60.22)2.49 (2.42 - 2.57)

 

Table 4. Relative Risk Assessment for the Clinical Classification of HF Inpatients Defined by ICD-10 Codes
 
Sociodemographic characteristicsSystolic HFCombined systolic-diastolic HFRight HFBiventricular HFEnd-stage HFOther undefined types
OR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P value
The data were represented as OR (95% CI). Statistical significance was determined to be at P <0.05, which was obtained via survey-based logistic regressions. ICD-10: International Classification of Diseases, 10th Revision; AA: African American; API: Asian-American and Pacific Islander; HF: heart failure; OR: odds ratio; CI: confidence interval.
Race/ethnicity
  White as the control group
  AA1.53 (1.48 - 1.59)< 0.00011.59 (1.52 - 1.66)< 0.00010.95 (0.84 - 1.07)0.411.50 (1.31 - 1.72)< 0.00011.71 (1.46 - 2.00)< 0.00011.99 (1.89 - 2.09)< 0.0001
  Hispanic1.29 (1.23 - 1.35)< 0.00011.20 (1.12 - 1.28)< 0.00010.86 (0.73 - 1.02)0.010.91 (0.75 - 1.10)0.401.30 (1.07 - 1.57)0.0072.45 (2.29 - 2.62)< 0.0001
  API1.21 (1.12 - 1.31)< 0.00011.20 (1.06 - 1.35)0.00471.10 (0.85 - 1.44)0.460.94 (0.68 - 1.29)0.701.12 (0.84 - 1.45)0.402.34 (2.12 - 2.57)< 0.0001
  Other racial/ethnic background1.28 (1.19 - 1.38)< 0.00011.14 (1.06 - 1.24)0.00071.12 (0.92 - 1.36)0.281.03 (0.82 - 1.30)0.811.26 (1.03 - 1.54)0.021.76 (1.60 - 1.93)< 0.0001
Sex
  Male as the control group
  Female0.39 (0.38 - 0.40)< 0.00010.48 (0.47 - 0.49)< 0.00010.81 (0.75 - 0.87)< 0.00010.47 (0.44 - 0.51)< 0.00010.36 (0.33 - 0.38)< 0.00010.66 (0.65 - 0.68)< 0.0001
Age group
  ≥ 75 as the control group
  18 - 344.43 (3.93 - 5.00)< 0.00013.07 (2.69 - 3.50)< 0.00018.40 (6.47 - 10.90)< 0.00015.68 (4.14 - 7.79)< 0.00017.56 (5.74 - 9.95)< 0.00015.76 (5.03 - 6.59)< 0.0001
  35 - 542.48 (2.38 - 2.58)< 0.00011.98 (1.88 - 2.07)< 0.00013.23 (2.84 - 3.67)< 0.00013.14 (2.78 - 3.55)< 0.00012.68 (2.35 - 3.07)< 0.00012.80 (2.66 - 2.94)< 0.0001
  55 - 741.50 (1.46 - 1.53)< 0.00011.35 (1.31 - 1.39)< 0.00011.72 (1.58 - 1.87)< 0.00011.76 (1.60 - 1.93)< 0.00011.60 (1.45 - 1.77)< 0.00011.82 (1.76 - 1.88)< 0.0001

 

Table 5. Relative Risk Assessment for Acuity of HF Diagnoses Using Chronic HF as Control
 
Sociodemographic characteristicsAcute vs. chronicAcute on chronic vs. chronicUnspecified acute or chronic vs. chronic
Adjusted OR (95% CI)P valueAdjusted OR (95% CI)P valueAdjusted OR (95% CI)P value
The data were represented as OR (95% CI). Statistical significance was determined to be at P <0.05, which was obtained via survey-based logistic regressions. AA: African American; API: Asian-American and Pacific Islander; HF: heart failure; OR: odds ratio; CI: confidence interval.
Race/ethnicity
  White as the control group
  African American0.67 (0.61 - 0.74)< 0.00010.99 (0.91 - 1.08)0.861.36 (1.23 - 1.49)< 0.0001
  Hispanic0.76 (0.67 - 0.86)< 0.00010.85 (0.76 - 0.95)0.0051.73 (1.50 - 2.00)< 0.0001
  API1.08 (0.85 - 1.37)0.530.91 (0.72 - 1.14)0.422.02 (1.52 - 2.69)< 0.0001
  Other racial/ethnic background0.79 (0.67 - 0.93)0.0040.81 (0.71 - 0.92)0.00171.22 (1.04 - 1.44)0.02
Sex
  Male as the control group
  Female1.21 (1.14 - 1.29)< 0.00011.07 (1.01 - 1.13)0.031.16 (1.07 - 1.25)0.0003
Age group
  ≥ 75 as the control group
  18 - 342.30 (1.74 - 3.04)< 0.00010.82 (0.63 - 1.07)0.132.03 (1.51 - 2.74)< 0.0001
  35 - 541.58 (1.42 - 1.77)< 0.00010.86 (0.77 - 0.95)0.0041.50 (1.33 - 1.70)< 0.0001
  55 - 741.14 (1.06 - 1.22)0.00050.91 (0.85 - 0.97)0.0041.30 (1.20 - 1.42)< 0.0001
Types of HF
  Diastolic HF as the control diagnosis
  Systolic HF1.10 (1.02 - 1.18)0.020.99 (0.92 - 1.06)0.740.73 (0.64 - 0.81)< 0.0001
  Combined systolic-diastolic HF0.76 (0.69 - 0.84)< 0.00011.49 (1.36 - 1.63)< 0.000111.36 (10.10 - 12.77)< 0.0001
  Right HF0.85 (0.66 - 1.10)0.250.75 (0.59 - 0.95)0.0210.01 (7.71 - 13.00)< 0.0001
  Biventricular HF0.46 (0.35 - 0.61)< 0.00010.79 (0.62 - 1.00)0.056.60 (5.02 - 8.67)< 0.0001
  End-stage HF0.07 (0.05 - 0.10)< 0.00010.51 (0.42 - 0.62)< 0.00015.54 (4.41 - 6.94)< 0.0001