Gad Cotter1, Beth A Davison2, Olga Milo2, Robert C Bourge3, John G F Cleland4, Guillaume Jondeau5, Henry Krum6, Christopher M O'Connor7, Marco Metra8, John D Parker9, Guillermo Torre-Amione10, Dirk J van Veldhuisen11, Isaac Kobrin12, Maurizio Rainisio13, Stefanie Senger2, Christopher Edwards2, John J V McMurray14, John R Teerlink15. 1. Momentum Research, Durham, North Carolina. Electronic address: gadcotter@momentum-research.com. 2. Momentum Research, Durham, North Carolina. 3. University of Alabama, Birmingham, Alabama. 4. University of Hull, Kingston Upon Hull, United Kingdom; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals NHS Trust, Imperial College, London, United Kingdom. 5. Service de Cardiologie, Hôpital Bichat, Paris, France. 6. Monash Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia. 7. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina. 8. University of Brescia, Piazza Spedali Civili, Brescia, Italy. 9. Division of Cardiology, Mount Sinai Hospital, Toronto, Ontario, Canada. 10. Methodist DeBakey Heart and Vascular Center, Methodist Hospital, Houston, Texas. 11. University Medical Centre, Groningen, The Netherlands. 12. Kobrin Associates, Basel, Switzerland. 13. Abanovus, Sanremo, Italy. 14. University of Glasgow, Glasgow, United Kingdom. 15. University of California San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
Abstract
BACKGROUND: The length of hospital stay (LOS) is important in patients admitted for acute heart failure (AHF) because it prolongs an unpleasant experience for the patients and adds substantially to health care costs. METHODS AND RESULTS: We examined the association between LOS and baseline characteristics, 10-day post-discharge HF readmission, and 90-day post-discharge mortality in 1347 patients with AHF enrolled in the VERITAS program. Longer LOS was associated with greater HF severity and disease burden at baseline; however, most of the variability of LOS could not be explained by these factors. LOS was associated with a higher HF risk of both HF readmission (odds ratio for 1-day increase: 1.08; 95% confidence interval [CI] 1.01-1.16; P = .019) and 90-day mortality (hazard ratio for 1-day increase: 1.05; 95% CI 1.02-1.07; P < .001), although these associations are partially explained by concurrent end-organ damage and worsening heart failure during the first days of admission. CONCLUSIONS: In patients who have been admitted for AHF, longer length of hospital stay is associated with a higher rate of short-term mortality. CLINICAL TRIAL REGISTRATION: VERITAS-1 and -2: Clinicaltrials.gov identifiers NCT00525707 and NCT00524433.
RCT Entities:
BACKGROUND: The length of hospital stay (LOS) is important in patients admitted for acute heart failure (AHF) because it prolongs an unpleasant experience for the patients and adds substantially to health care costs. METHODS AND RESULTS: We examined the association between LOS and baseline characteristics, 10-day post-discharge HF readmission, and 90-day post-discharge mortality in 1347 patients with AHF enrolled in the VERITAS program. Longer LOS was associated with greater HF severity and disease burden at baseline; however, most of the variability of LOS could not be explained by these factors. LOS was associated with a higher HF risk of both HF readmission (odds ratio for 1-day increase: 1.08; 95% confidence interval [CI] 1.01-1.16; P = .019) and 90-day mortality (hazard ratio for 1-day increase: 1.05; 95% CI 1.02-1.07; P < .001), although these associations are partially explained by concurrent end-organ damage and worsening heart failure during the first days of admission. CONCLUSIONS: In patients who have been admitted for AHF, longer length of hospital stay is associated with a higher rate of short-term mortality. CLINICAL TRIAL REGISTRATION: VERITAS-1 and -2: Clinicaltrials.gov identifiers NCT00525707 and NCT00524433.
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