Contemporary Issues in the Pharmacologic Management of Acute Heart Failure

Characteristics, drug therapy, and outcomes from a database of 500,000 hospitalized patients with a discharge diagnosis of heart failure

Knowledge related to acute heart failure (HF) and its management in "real-world" clinical practice is limited. The authors delineated characteristics and drug therapy for hospitalized HF patients and their association with clinical and economic outcomes. The NDCHealth (National Data Corporation, Atlanta, GA) database, containing billing data from a geographically diverse sample of approximately 300 hospitals, was screened for admissions in 2003 of either a primary or secondary discharge diagnosis of HF. Of 2.5 million admissions screened, 496,534 patients (19.7%) had a primary (131,057) or secondary (365,477) discharge diagnosis of HF. Mean age was 73.1+/-13.9 years, and 55.4% were women. Mean length of hospital stay was 8.7+/-28.6 days, and in-hospital mortality was 7.1%. Mean hospital cost per admission was dollars 18,667. Admissions with HF as a secondary diagnosis were associated with a worse prognosis. HF commonly exists in hospitalized patients and is associated with significant morbidity, mortality, and economic burden, irrespective of whether it is the primary diagnosis or a secondary comorbidity.