Unraveling Disparities in Right Heart Failure: A Comprehensive Analysis of Demographics, Socioeconomic Factors, and Mortality Predictors in a 117,633-Patient Cohort (2017-2020)

Author(s)

Rao A1, Agrawal A1, Garyali A2, Kumar D3, Sarna A4, Akkanti B5
1University of Texas School of Public Health, Houston, TX, USA, 2Rice University, Houston, TX, USA, 3UT Austin, Missouri City , TX, USA, 4UT Austin, Austin, TX, USA, 5McGovern Medical School, Houston, TX, USA

Presentation Documents

OBJECTIVES: Our study is a comprehensive analysis of a substantial patient cohort diagnosed with Right Heart Failure (RHF), totaling 117,633 individuals over four years (2017-2020) and involving 70,490,815 unweighted discharges from the national readmission database supplied by AHRQ. The primary aim is to discern variations within sub-cohorts of patients who succumbed to RHF.

METHODS: Leveraging the AHRQ NRD Claims database, we analyzed 117,633 patients discharged with a diagnosis of right heart failure. The study delves into baseline characteristics, comparing survivors and non-survivors, exploring indicators like comorbidities, median household income, total charges, and readmissions characteristics. Mortality predictors are identified through adjusted odds ratios.

RESULTS: Among 117,633 patients, 12,305 (10.46%) died during the index admission. Significant differences were found in age, with non-survivors having an average age of 66.45 (SD 15.67) compared to 68.72 (SD 14.62) in survivors (p<0.001). A majority of non-survivors were aged over 65, reaching statistical significance (p<0.001). More non-survivors stayed >=7 days (46%) compared to survivors (42%) (p<0.001). Non-survivors had higher total charges >=$100k (51% vs. 27%, p<0.001). Both groups predominantly had Medicare insurance (68.55% vs. 66.58%, p<0.001). Comorbidities like Myocardial infarction, Peripheral Vascular Disease, Cerebrovascular disease, Rheumatoid disease, Moderate/Severe Liver Disease, metastatic cancer, and COVID-19 were significantly higher in non-survivors. CCI >=4 was 56% in non-survivors and 48.96% in survivors. Adjusted odds ratio analysis revealed higher odds for age (1.76), female (1.09), LOS>=7 days (1.1), Myocardial infarction (1.791), COVID-19 (5.971), and CCI >=4 (1.145). The readmission rate over four years was 14.54%.

CONCLUSIONS: This study provides valuable insights into the patient profile and outcomes associated with Right Heart Failure, highlighting disparities in demographics, socioeconomic factors, and comorbidities. Mortality predictors emphasize the need for considering multiple factors in clinical decision-making. Findings hold implications for healthcare professionals and policymakers in tailoring interventions for improved outcomes in individuals affected by Right Heart Failure.

Conference/Value in Health Info

2024-05, ISPOR 2024, Atlanta, GA, USA

Value in Health, Volume 27, Issue 6, S1 (June 2024)

Code

RWD117

Topic

Clinical Outcomes, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory)

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