Abstract 20092: Acute Decompensated Valvular Heart Failure Results in Shorter Hospital Stays but Higher Readmission Rates Compared to Non-Valvular Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Among patients hospitalized with acute decompensated heart failure (ADHF), the prevalence of valvular disease is unknown. Furthermore, differences in length of stay (LOS) and readmission rates (RAR) between patients with acute decompensated valvular heart failure (ADVHF) and acute decompensated non-valvular heart failure (ADnVHF) have not been studied.
Hypothesis: Hospital LOS and RARs differ between patients admitted with ADVHF and ADnVHF.
Methods: The Atherosclerosis Risk in Communities (ARIC) study classified hospitalized ADHF patients in 4 U.S. communities within its study cohort (Cohort Component) and in a random stratified sample of community hospitalized patients (Surveillance Component). The Cohort followed 15,792 individuals 45-64yo since 1987, and the Surveillance followed a weighted sample of over 470,000 hospitalized patients ≥55 yo. The prevalence of at least moderate mitral and aortic valvular disease and hospital LOS within the surveillance population, as well as RAR within the cohort population, were analyzed using linear and Cox regression analyses.
Results: Between 2005-2011, 15,397 ADHF hospitalizations were validated within the surveillance population, of which 44% had ADVHF. ADVHF patients were older, more often white, and less likely to have diabetes, COPD, or need dialysis (p<0.05). The prevalence of valvular lesions were: mitral regurgitation (63%) or stenosis (2%), aortic regurgitation (7%) or stenosis (8%), and mixed aortic/mitral disease (20%). ADVHF patients had a shorter mean LOS compared to ADnVHF patients (7.9 vs 9.2 days, 95% CI -2.4 to -0.3). Among 991 Cohort population hospitalizations, ADVHF had an increased RAR at 28 days (14% vs 7%,HR 1.6, 95% CI 1.0 to 2.6) and 1 year (32% vs 26%,HR 1.3, 95% CI 1.0 to 1.6). When adjusting for age, race, sex, and ejection fraction, the 28-day (HR 2.1, 95% CI 1.2 to 3.6) and 1-year (HR 1.3, 95% CI 1.0 to 1.7) RAR remained higher in the ADVHF population.
Conclusions: Isolated mitral regurgitation is the most common valvular heart disease in patients admitted with ADHF. Patients with ADVHF have shorter initial hospital LOS but a higher RAR at 28-days and 1-year. These data provide insight that patients with AHVDF may need closer follow-up to prevent rehospitalizations.
Author Disclosures: M. Sola: None. M. Caughey: None. A. Husain: None. P. Chang: None. C. Ramm: None. M. Yeung: None. A. Shah: None. K. Matsushita: None. D. Kitzman: None. J. Vavalle: None.
- © 2016 by American Heart Association, Inc.