Abstract 265: Impact of Bleeding on Length of Stay and Inpatient Cost Among Atrial Fibrillation Patients Hospitalized for Congestive Heart Failure
| Autor: | Alpesh N Amin, Bruce D Bowdy, Bernadette H Johnson, Yonghua Jing, Scott B Robinson, Daniel Wiederkehr |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 6 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.6.suppl_1.a265 |
| Popis: | OBJECTIVES: To determine the impact of hospital acquired bleeding in atrial fibrillation (AF) patients admitted for congestive heart failure (CHF) on length of stay (LOS) and total hospitalization cost. METHODS: The Premier research database was queried to identify adult inpatients discharged between 2008 and 2011 with a primary diagnosis code of CHF and a secondary code of AF in whom bleeding was not present on admission. Bleeding was identified using ICD-9 diagnosis codes or charge codes for fresh frozen plasma, blood, or transfusion of blood or blood components. In univariate comparisons of patients with and without bleeding, t-tests for continuous variables and chi-squared tests for categorical variables were used (alpha = 0.05). Gamma regression adjusting for demographics, comorbidities and antiplatelet/anticoagulant use were utilized to produce estimates for mean LOS and total hospitalization cost among patients with and without bleeding. RESULTS: There were 76,245 patients, average age of 77.4 (SD 11.8) that met the study criteria. Across the entire population, mean LOS was 5.74 (SD 4.54) days, and mean total cost was $11,963 (SD 14,852). Overall, 4,159 (5.5%) patients had a bleed during their hospitalization. After adjustment, the mean estimated LOS was 9.49 (95% CI 9.30-9.68) days in the bleed group and 5.40 (95% CI 5.37-5.42) days in the no bleed group. The adjusted mean estimated total hospitalization cost was greater in the bleed group $21,941 (95% CI 21,425-22,467) vs. $10,757 (95% CI 10,696-10,817) in the no bleed group. Sensitivity analyses adjusting for cardiac related procedures resulted in numerical differences in the estimates, but not the direction or significance of the outcomes. CONCLUSIONS: Occurrence of hospital acquired bleeding in AF patients with CHF is associated with a significant increase in the LOS and total hospitalization cost. In this study, adjustment for demographic and comorbidity differences as well as the use of antiplatelets and anticoagulants did not change the magnitude or direction of these associations, though residual confounding cannot be ruled out. In this cohort, bleeding was associated with approximately additional $47 million dollars in cost and 17,000 additional hospital days. |
| Databáze: | OpenAIRE |
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