Abstract
Background: Heart failure (HF) with preserved ejection fraction (HFpEF) is more common in women than in men; data characterizing sex differences in the management and outcomes of HFpEF patients presenting to the emergency department (ED) are limited. Methods and Results: Using Acute Decompensated Heart Failure National Registry Emergency Module data linked to Medicare claims, we conducted a retrospective analysis of acute HF patients in the ED, identifying HFpEF (ejection fraction [EF] ≥40%) patients and stratifying by sex to compare baseline characteristics, ED therapies, hospital length of stay (LOS), in-hospital mortality, and post-discharge outcomes. Of 4161 HFpEF patients, 2808 (67%) were women, who were more likely to be older and hypertensive, but less likely to be diabetic or smokers (all P <.01). Women more often presented with systolic blood pressure >140 mm Hg (62.5% vs 56.4%; P = .0001) and higher EF. There were no sex differences in ED therapies, adjusted 30- and 180-day all-cause mortality, in-hospital mortality, or 30- and 180-day readmissions. After adjustment, women had longer LOS (0.40 days, 95% confidence interval [CI] 0.10-0.70; P = .008). Conclusions: Women with HFpEF presenting to the ED were more likely to have elevated systolic blood pressure, but overall ED management strategies were similar to those in men. We observed adjusted differences in hospital LOS, but no differences in 30- and 180-day outcomes.
| Original language | English (US) |
|---|---|
| Journal | Journal of Cardiac Failure |
| DOIs | |
| State | Accepted/In press - Jun 29 2015 |
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Keywords
- Heart failure with preserved ejection fraction
- Sex differences in management
- Sex differences in outcomes
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Sex Differences in the Management and Outcomes of Heart Failure With Preserved Ejection Fraction in Patients Presenting to the Emergency Department With Acute Heart Failure. / Zsilinszka, Reka; Shrader, Peter; DeVore, Adam D.; Hardy, N. Chantelle; Mentz, Robert J.; Pang, Peter; Peacock, W. Frank; Fonarow, Gregg C.; Hernandez, Adrian F.
In: Journal of Cardiac Failure, 29.06.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sex Differences in the Management and Outcomes of Heart Failure With Preserved Ejection Fraction in Patients Presenting to the Emergency Department With Acute Heart Failure
AU - Zsilinszka, Reka
AU - Shrader, Peter
AU - DeVore, Adam D.
AU - Hardy, N. Chantelle
AU - Mentz, Robert J.
AU - Pang, Peter
AU - Peacock, W. Frank
AU - Fonarow, Gregg C.
AU - Hernandez, Adrian F.
PY - 2015/6/29
Y1 - 2015/6/29
N2 - Background: Heart failure (HF) with preserved ejection fraction (HFpEF) is more common in women than in men; data characterizing sex differences in the management and outcomes of HFpEF patients presenting to the emergency department (ED) are limited. Methods and Results: Using Acute Decompensated Heart Failure National Registry Emergency Module data linked to Medicare claims, we conducted a retrospective analysis of acute HF patients in the ED, identifying HFpEF (ejection fraction [EF] ≥40%) patients and stratifying by sex to compare baseline characteristics, ED therapies, hospital length of stay (LOS), in-hospital mortality, and post-discharge outcomes. Of 4161 HFpEF patients, 2808 (67%) were women, who were more likely to be older and hypertensive, but less likely to be diabetic or smokers (all P <.01). Women more often presented with systolic blood pressure >140 mm Hg (62.5% vs 56.4%; P = .0001) and higher EF. There were no sex differences in ED therapies, adjusted 30- and 180-day all-cause mortality, in-hospital mortality, or 30- and 180-day readmissions. After adjustment, women had longer LOS (0.40 days, 95% confidence interval [CI] 0.10-0.70; P = .008). Conclusions: Women with HFpEF presenting to the ED were more likely to have elevated systolic blood pressure, but overall ED management strategies were similar to those in men. We observed adjusted differences in hospital LOS, but no differences in 30- and 180-day outcomes.
AB - Background: Heart failure (HF) with preserved ejection fraction (HFpEF) is more common in women than in men; data characterizing sex differences in the management and outcomes of HFpEF patients presenting to the emergency department (ED) are limited. Methods and Results: Using Acute Decompensated Heart Failure National Registry Emergency Module data linked to Medicare claims, we conducted a retrospective analysis of acute HF patients in the ED, identifying HFpEF (ejection fraction [EF] ≥40%) patients and stratifying by sex to compare baseline characteristics, ED therapies, hospital length of stay (LOS), in-hospital mortality, and post-discharge outcomes. Of 4161 HFpEF patients, 2808 (67%) were women, who were more likely to be older and hypertensive, but less likely to be diabetic or smokers (all P <.01). Women more often presented with systolic blood pressure >140 mm Hg (62.5% vs 56.4%; P = .0001) and higher EF. There were no sex differences in ED therapies, adjusted 30- and 180-day all-cause mortality, in-hospital mortality, or 30- and 180-day readmissions. After adjustment, women had longer LOS (0.40 days, 95% confidence interval [CI] 0.10-0.70; P = .008). Conclusions: Women with HFpEF presenting to the ED were more likely to have elevated systolic blood pressure, but overall ED management strategies were similar to those in men. We observed adjusted differences in hospital LOS, but no differences in 30- and 180-day outcomes.
KW - Heart failure with preserved ejection fraction
KW - Sex differences in management
KW - Sex differences in outcomes
UR - http://www.scopus.com/inward/record.url?scp=84956599544&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84956599544&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2015.12.008
DO - 10.1016/j.cardfail.2015.12.008
M3 - Article
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
ER -