دورية أكاديمية
Differential impact of systolic and diastolic heart failure on in-hospital treatment, outcomes, and cost of patients admitted for pneumonia
| العنوان: | Differential impact of systolic and diastolic heart failure on in-hospital treatment, outcomes, and cost of patients admitted for pneumonia |
|---|---|
| المؤلفون: | Jessica El Halabi, Essa Hariri, Quinn R. Pack, Ning Guo, Pei-Chun Yu, Niti G. Patel, Peter B. Imrey, Michael B. Rothberg |
| المصدر: | American Journal of Medicine Open, Vol 9, Iss , Pp 100025- (2023) |
| بيانات النشر: | Elsevier, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Medicine |
| مصطلحات موضوعية: | Systolic heart failure, Diastolic heart failure, Pneumonia, Medicine |
| الوصف: | Background: Patients admitted with pneumonia and heart failure (HF) have increased mortality and cost compared to those without HF, but it is not known whether outcomes differ between systolic and diastolic HF. Management of concomitant pneumonia and HF is complicated because HF treatments can worsen complications of pneumonia. Methods: This is a retrospective cohort study from the Premier Database among patients admitted with pneumonia between 2010 and 2015. Patients were categorized based on systolic, diastolic, and combined HF using ICD-9 codes. The primary outcome was in-hospital mortality. Secondary outcomes included use of HF medications, length of stay, cost, intensive care unit (ICU) admission, as well as use of invasive mechanical ventilation (IMV), vasopressors and inotropes. Multivariable logistic regression was used to describe associations of these outcomes with type of HF. Results: Of 123,211 patients with pneumonia and HF, 41,196 (33.4%) had systolic HF, 69,982 (56.8%) diastolic HF, and 12,033 (9.8%) had combined HF. Compared to patients with diastolic HF, after multivariable adjustment systolic HF was associated with higher in-hospital mortality (OR 1.15; 95% CI:1.11–1.20), ICU admission, and use of IMV and vasoactive agents, but not with increased length of stay or cost. Among patients with systolic HF, 80% received a loop diuretic, 72% a beta blocker, 48% angiotensin converting enzyme inhibitor or angiotensin receptor blocker, and 12.5% a mineralocorticoid receptor antagonist. Conclusion: Systolic HF is associated with added risk in pneumonia compared to diastolic HF. There may also be an opportunity to optimize medications in systolic HF prior to discharge. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2667-0364 03184722 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2667036422000206; https://doaj.org/toc/2667-0364 |
| DOI: | 10.1016/j.ajmo.2022.100025 |
| URL الوصول: | https://doaj.org/article/7097ac6d03184722ad36d100759c2596 |
| رقم الأكسشن: | edsdoj.7097ac6d03184722ad36d100759c2596 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 26670364 03184722 |
|---|---|
| DOI: | 10.1016/j.ajmo.2022.100025 |