tetano
Editor, Senior Moderator
Mayo Clin Proc
. 2023 Jan;98(1):31-47.
doi: 10.1016/j.mayocp.2022.09.005. Epub 2022 Sep 21.
Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020
Mohammed Yousufuddin[SUP] 1 [/SUP], Mohamad H Yamani[SUP] 2 [/SUP], Kianoush B Kashani[SUP] 3 [/SUP], Ye Zhu[SUP] 4 [/SUP], Zhen Wang[SUP] 4 [/SUP], Ashok Seshadri[SUP] 5 [/SUP], Katherine R Blocker[SUP] 6 [/SUP], Jessica L Peters[SUP] 6 [/SUP], Jewell M Doss[SUP] 6 [/SUP], Dhauna Karam[SUP] 6 [/SUP], Kanika Khandelwal[SUP] 6 [/SUP], Umesh M Sharma[SUP] 7 [/SUP], Daniel V Dudenkov[SUP] 8 [/SUP], Tahir Mehmood[SUP] 9 [/SUP], Sandeep R Pagali[SUP] 9 [/SUP], Sanjeev Nanda[SUP] 10 [/SUP], Ahmed D Abdalrhim[SUP] 10 [/SUP], Nichole Cummings[SUP] 11 [/SUP], Sagar B Dugani[SUP] 9 [/SUP], Michael Smerina[SUP] 8 [/SUP], Larry J Prokop[SUP] 12 [/SUP], Lawrence R Keenan[SUP] 13 [/SUP], Sumit Bhagra[SUP] 14 [/SUP], Arshad Jahangir[SUP] 15 [/SUP], Philippe R Bauer[SUP] 16 [/SUP], Gregg C Fonarow[SUP] 17 [/SUP], Mohammad Hassan Murad[SUP] 18 [/SUP]
Affiliations
Abstract
Objective: To compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.
Patients and methods: The study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations: 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.
Results: The adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).
Conclusion: The findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.
. 2023 Jan;98(1):31-47.
doi: 10.1016/j.mayocp.2022.09.005. Epub 2022 Sep 21.
Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020
Mohammed Yousufuddin[SUP] 1 [/SUP], Mohamad H Yamani[SUP] 2 [/SUP], Kianoush B Kashani[SUP] 3 [/SUP], Ye Zhu[SUP] 4 [/SUP], Zhen Wang[SUP] 4 [/SUP], Ashok Seshadri[SUP] 5 [/SUP], Katherine R Blocker[SUP] 6 [/SUP], Jessica L Peters[SUP] 6 [/SUP], Jewell M Doss[SUP] 6 [/SUP], Dhauna Karam[SUP] 6 [/SUP], Kanika Khandelwal[SUP] 6 [/SUP], Umesh M Sharma[SUP] 7 [/SUP], Daniel V Dudenkov[SUP] 8 [/SUP], Tahir Mehmood[SUP] 9 [/SUP], Sandeep R Pagali[SUP] 9 [/SUP], Sanjeev Nanda[SUP] 10 [/SUP], Ahmed D Abdalrhim[SUP] 10 [/SUP], Nichole Cummings[SUP] 11 [/SUP], Sagar B Dugani[SUP] 9 [/SUP], Michael Smerina[SUP] 8 [/SUP], Larry J Prokop[SUP] 12 [/SUP], Lawrence R Keenan[SUP] 13 [/SUP], Sumit Bhagra[SUP] 14 [/SUP], Arshad Jahangir[SUP] 15 [/SUP], Philippe R Bauer[SUP] 16 [/SUP], Gregg C Fonarow[SUP] 17 [/SUP], Mohammad Hassan Murad[SUP] 18 [/SUP]
Affiliations
- PMID: 36603956
- DOI: 10.1016/j.mayocp.2022.09.005
Abstract
Objective: To compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.
Patients and methods: The study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations: 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.
Results: The adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).
Conclusion: The findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.