Characteristics,Treatment Patterns,and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic,March to October 2020 |
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Institution: | 1. Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN;2. Division of Psychiatry, Mayo Clinic Health System, Austin, MN;3. Division of Cardiology, Mayo Clinic Health System, Austin, MN;4. Division of Endocrinology, Mayo Clinic Health System, Austin, MN;5. Division of Cardiology, Mayo Clinic, Jacksonville, FL;6. Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL;7. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN;8. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN;9. Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN;10. Division of General Internal Medicine, Mayo Clinic, Rochester, MN;11. Library and Public Services, Mayo Clinic, Rochester, MN;12. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN;13. Division of Preventive and Occupational Medicine, Mayo Clinic, Rochester, MN;14. Hospital Internal Medicine, Mayo Clinic, Phoenix, AZ;15. Division of Hospital Internal Medicine, St. Cloud Hospital, St. Cloud, MN;p. Aurora Cardiovascular and Thoracic Services, Aurora St. Luke’s Medical Center, Milwaukee, WI;q. Division of Cardiology, University of California Los Angeles, Los Angeles, CA |
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Abstract: | ObjectiveTo 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 MethodsThe 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.ResultsThe 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).ConclusionThe 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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Keywords: | ADHF"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"acute decompensated heart failure AMI"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"acute myocardial infarction BMI"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"body mass index COVID-19"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"coronavirus disease 2019 EF"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"ejection fraction HF"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"heart failure LVEF"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"left ventricular ejection fraction SBP"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"systolic blood pressure STROBE"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"Strengthening the Reporting of Observational Studies in Epidemiology |
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