Cardiac amyloidosis is an increasingly recognized cause of heart failure with preserved
or mildly reduced ejection fraction with emerging treatment options. We sought to
analyze the temporal trends and impact of hospital admissions in patients with amyloidosis.
The National Inpatient Sample was queried to identify patients from 2005 to 2014 who
were hospitalized with a diagnosis of amyloidosis using ICD9 codes. Trends over time
of prevalence, demographics, co-morbidities, and outcomes were described. Propensity-matching
was used to assess the impact of amyloidosis on in-hospital outcomes, including mortality.
A total of 156,914 admissions in patients with amyloidosis (age 69.86 +/− 12.33 years,
45.7% female, 68.5% Caucasian) were identified. Hospitalizations more than doubled
with a peak of 21,740 per year and 62 per 100,000 admissions in 2014. Over time, patients
admitted with amyloidosis were older and more likely to have co-morbid medical conditions.
A diagnosis of heart failure was present in 34.7% of patients, increased over time
(p = 0.001), and was associated with further morbidity and mortality. In a propensity-matched
analysis, patients admitted with amyloidosis had a longer length of stay (7.5 vs 6.2
days), were less likely to be discharged home (43.6% vs 48.7%), and were more likely
to die during the hospitalization (7.4% vs 4.9%, p <0.001 for all). In conclusion,
inpatient hospitalizations in the United States in patients with amyloidosis have
increased over time and are associated with high morbidity and mortality, particularly
when there is concomitant heart failure.
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Article info
Publication history
Published online: September 10, 2019
Received in revised form:
August 15,
2019
Received:
July 4,
2019
Footnotes
Funding: This work was funded by an ASPIRE grant WI241765 from Pfizer Global Medical Grants.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
