Introduction: Heart Failure with Preserved Ejection Fraction (HFpEF) and Heart Failure with Reduced Ejection Fraction (HFrEF) share similar clinical phenotype however might lead to different outcomes. There is limited data comparing the hospitalization outcomes between HFpEF and HFrEF.
Hypothesis: Outcomes in patients hospitalized with HFpEF and HFrEF are similar.
Methods: This was a retrospective cohort study using the 2014 National Inpatient Sample (NIS) of adult patients hospitalized with HFpEF or HFrEF as the principal diagnosis. The primary outcomes were in-hospital mortality, mean length of stay (LOS) and mean total hospital charges. The secondary outcomes included ICU admission, shock, acute respiratory failure, and encounter for palliative care. Multivariable regression analysis was used to adjust for age, gender, race, Charlson Comorbidity Index, median annual income and hospital bed size.
Results: A total of 586,510 patients with HFpEF or HFrEF were included in our study, and 46.9% of patients (275,340) were admitted with HFpEF. We found that patients with HFpEF were older (75 vs 70 years) and more likely female (62.6% vs 37.9%) than those with HFrEF (both P<0.001). Compared to patients with HFrEF, patients with HFpEF had lower in-hospital mortality (2.3% vs 2.7%), lower mean LOS (5.2 vs 5.4 days) and lower mean total hospital charges (US$ 38640 vs 48171) (all P<0.001). Similarly, regarding the secondary outcomes, patients with HFpEF had significantly lower rates of ICU admission (odds ratio [OR]: 0.67, 95% confidence interval [CI], 0.62-0.74), shock (OR: 0.39, 95% CI, 0.32-0.49), and encounter for palliative care (OR: 0.68, 95% CI, 0.64-0.73) (all P<0.001). However, the incidence of acute respiratory failure was statistically higher in patients with HFpEF (OR: 1.18, 95% CI, 1.15-1.23).
Conclusions: Patients hospitalized with HFpEF had lower in-hospital mortality, shorter length of stay and lower healthcare costs compared to patients with HFrEF.