TY - JOUR
T1 - Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020
AU - Yousufuddin, Mohammed
AU - Yamani, Mohamad H.
AU - Kashani, Kianoush B.
AU - Zhu, Ye
AU - Wang, Zhen
AU - Seshadri, Ashok
AU - Blocker, Katherine R.
AU - Peters, Jessica L.
AU - Doss, Jewell M.
AU - Karam, Dhauna
AU - Khandelwal, Kanika
AU - Sharma, Umesh M.
AU - Dudenkov, Daniel V.
AU - Mehmood, Tahir
AU - Pagali, Sandeep R.
AU - Nanda, Sanjeev
AU - Abdalrhim, Ahmed D.
AU - Cummings, Nichole
AU - Dugani, Sagar B.
AU - Smerina, Michael
AU - Prokop, Larry J.
AU - Keenan, Lawrence R.
AU - Bhagra, Sumit
AU - Jahangir, Arshad
AU - Bauer, Philippe R.
AU - Fonarow, Gregg C.
AU - Murad, Mohammad Hassan
N1 - Funding Information:
Grant Support: This work was supported by the Mayo Clinic Health System and grant K23 MD016230 from the National Institutes of Health / National Institute on Minority Health and Health Disparities (S.B.D.).
Publisher Copyright:
© 2022 The Authors
PY - 2023/1
Y1 - 2023/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.mayocp.2022.09.005
DO - 10.1016/j.mayocp.2022.09.005
M3 - Article
C2 - 36603956
AN - SCOPUS:85144933365
SN - 0025-6196
VL - 98
SP - 31
EP - 47
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 1
ER -