부산대학교 도서관

Introduction: The economic burden associated with heart failure (HF) is expected to increase in the world due to aging. Left ventricular ejection fraction (LVEF) is a basic clinical index that indicates the severity of HF, and guideline-directed medical therapies are recommended stratified by LVEF. However, there is paucity of information between LVEF and hospitalization costs.Hypothesis: Therefore, we evaluated the association between the hospitalization costs and LVEF in elder HF patients in Japan, which is at forefront of aging.Methods: We studied 346 consecutive patients who admitted to Miyazaki prefectural Nobeoka Hospital due to HF between January 2015 and March 2018.Results: Median hospitalization costs were comparable between the HF reduced EF (HFrEF; LVEF<40%: n=129) and HF preserved EF (HFpEF; LVEF≥40%: n=217) ($7128 vs $6580, P=0.373), LVEF was not correlated with hospitalization costs (P=0.051) (Figure A). Meanwhile, in the subgroup aged over 75 years, median hospitalization costs were significantly higher in HFrEF than in HFpEF ($7249 vs $6471, P=0.031). The HFrEF group also had higher level of brain natriuretic peptide (1011 vs 479 pg/ml, P<0.001), higher prevalence of ischemic heart disease (40% vs 27%, P=0.004), and higher rate of percutaneous coronary intervention (10% vs 2%, P=0.008) than HFpEF group. In addition, LVEF was significantly correlated with hospitalization costs (P=0.005) (Figure B), and remained as a significant independent predictor of hospitalization costs in multivariate liner regression analysis (β=—0.173, P=0.014).Conclusions: LVEF was not significantly correlated with hospitalization costs in the entire cohort, but was an independent negative factor for hospitalization costs in the subgroup of aged over 75. This might provide helpful evidence for future novel healthcare strategies that target HF inpatient cost reductions.