Open Access Highly Accessed Research article

Comorbidity profiles and inpatient outcomes during hospitalization for heart failure: an analysis of the U.S. Nationwide inpatient sample

Christopher S Lee1*, Christopher V Chien2, Julie T Bidwell3, Jill M Gelow2, Quin E Denfeld3, Ruth Masterson Creber4, Harleah G Buck5 and James O Mudd2

Author Affiliations

1 Oregon Health & Science University School of Nursing and Knight Cardiovascular Institute, 3455 SW US Veterans Hospital Road, Portland, OR 97239-2941, USA

2 Oregon Health & Science University Knight Cardiovascular Institute, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA

3 Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR 97239-2941, USA

4 University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA

5 The Pennsylvania State University College of Nursing, 201 Health and Human Development East University Park, Philadelphia, PA 16802, USA

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BMC Cardiovascular Disorders 2014, 14:73  doi:10.1186/1471-2261-14-73

Published: 5 June 2014

Abstract

Background

Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.

Methods

Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (nā€‰=ā€‰192,327).

Results

Most discharges were characterized by "common" comorbidities. A "lifestyle" profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A "renal" profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A "neurovascular" profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15% longer length of stay (LOS) and 12% greater cost, the renal profile was associated with a 30% higher risk of death, 27% longer LOS and 24% greater cost, and the neurovascular profile was associated with a 45% higher risk of death, 34% longer LOS and 37% greater cost (all pā€‰<ā€‰0.001).

Conclusions

Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.

Keywords:
Heart failure; Comorbidity; Outcomes; Inpatient