National Outcomes in Hospitalized Patients With Cancer and Comorbid Heart Failure

• Published in: Journal of cardiac failure 2019-07, Vol.25 (7), p.516-521
• Main Authors: Tuzovic, Mirela, Yang, Eric H., Sevag Packard, RenÉ R., Ganz, Patricia A., Fonarow, Gregg C., Ziaeian, Boback
• Format: Article
• Language: English
• Subjects: Aged; Cancer; Comorbidity; Cost of Illness; Databases, Factual - statistics & numerical data; Female; heart failure; Heart Failure - diagnosis; Heart Failure - mortality; Hospital Mortality; hospitalization; Hospitalization - statistics & numerical data; Humans; Length of Stay - statistics & numerical data; Male; Neoplasms - economics; Neoplasms - epidemiology; Neoplasms - pathology; Patient Acceptance of Health Care - statistics & numerical data; Prognosis; Risk Assessment - methods; Risk Factors; United States
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2019.02.007

•Hospitalized cancer patients with heart failure have a high incidence of comorbidities, including hypertension, coronary artery disease, and diabetes mellitus.•Cancer patients with comorbid heart failure admitted for a primary oncologic diagnosis have a strikingly high inpatient mortality of 12.2%.•Presence of heart failure is associated with higher risk of inpatient mortality, whereas female sex is protective against inpatient mortality.•Patients with either leukemia or lung cancer and comorbid heart failure have the highest risk of death during hospitalization.•More research is needed to determine if targeted heart failure screening measures, such as biomarkers or imaging, can improve outcomes for hospitalized cancer patients. Heart failure (HF) and cancer are a significant cause of morbidity and mortality in the US. Due to overlapping risk factors, these two conditions often coexist. We sought to describe the national burden of HF for hospitalized patients with cancer. We identified adults admitted with a primary oncologic diagnosis in 2014 included in the National Inpatient Sample (NIS). Patient hospitalizations were divided based on presence or absence of comorbid HF. Primary outcomes included cost, length of stay (LOS), and inpatient mortality. Logistic regression analysis with cluster adjustment was performed to determine predictors of inpatient mortality. There were 834,900 admissions for a primary oncologic diagnosis in patients without comorbid HF, and 64,740 (7.2%) admissions for patients with comorbid HF. Patients with HF were on average older and had more comorbidities. Patients with HF had significantly higher mean hospitalization cost ($22,571 vs $20,234, p-value