Heart failure (HF) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are considered significant causes of morbidity and mortality worldwide. Concurrent presentation of HF with AECOPD can pose a diagnostic challenge due to an overlap in symptomatology. We queried the National Inpatient Sample (NIS) database to assess outcomes of HF hospitalizations with a secondary diagnosis of AECOPD. We performed a retrospective analysis of discharge data from the Healthcare Cost Utilization Project NIS between January 1, 2004, and December 31, 2014, with a primary diagnosis of HF with and without a secondary diagnosis of AECOPD. Data was abstracted from the NIS using International Classification of Disease 9 codes. Primary outcomes included mortality, length of stay, and inflation-adjusted cost of stay. During 2004-2014, a total of (n = 10,392,628) HF hospitalizations were identified without a secondary diagnosis of AECOPD while (n = 989,713) HF hospitalizations were identified with a secondary diagnosis of AECOPD. We identified higher mortality (3.25% vs 3.56%, p <0.001), length of stay (5.2 vs 6.1 days, p <0.001) and inflation-adjusted cost of stay (12,562 vs 13,072 USD, p <0.001) in HF hospitalizations with AECOPD when compared to HF without AECOPD from 2004 to 2014. We presented AECOPD as an independent predictor of mortality in patients admitted for HF. In conclusion, further interdisciplinary collaboration between pulmonologists and cardiologists is needed for the identification and stratification of patients who present with concurrent HF and COPD for better outcomes.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to American Journal of Cardiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Heart disease and stroke statistics—2020 update: a report from the American Heart Association.Circulation. 2020; 141: E139-E596
- Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010.Lancet. 2012; 380: 2163-2196
- Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology.Eur J Heart Fail. 2009; 11: 130-139
- Diagnostic accuracy of clinical criteria for identifying systolic and diastolic heart failure: cross-sectional study.J Eval Clin Pract. 2009; 15: 55-61
- Temporal trends and patterns in mortality after incident heart failure: a longitudinal analysis of 86000 individuals.JAMA Cardiol. 2019; 4: 1102-1111
- Epidemiology and aetiology of heart failure.Nat Rev Cardiol. 2016; 13: 368-378
- Trends in outcomes, financial burden, and mortality for acute exacerbation of chronic obstructive pulmonary disease (COPD) in the United States from 2002 to 2010.COPD J Chronic Obstr Pulm Dis. 2017; 14: 72-79
- The clinical and economic burden of chronic obstructive pulmonary disease in the USA.Clin Outcomes Res. 2013; 5: 235-245
- Impact and prevention of severe exacerbations of COPD: a review of the evidence.Int J COPD. 2017; 12: 2891-2908
- Tobacco product use among adults — United States, 2017.MMWR Morb Mortal Wkly Rep. 2018; 67: 1225-1232
- Trends in Hospital Inpatient Stays by Age and Payer, 2000–2015: Statistical Brief #235.Agency for Healthcare Research and Quality, Rockville (MD) (US)2006
- Cost analysis of hospitalized patients with chronic obstructive pulmonary disease: a state-level cross-sectional study.Tanaffos. 2016; 15: 75-82
- Cardiorenal syndrome: an overview.Adv Chronic Kidney Dis. 2018; 25: 382-390
- Incidence, risk factors, and prognostic implications of acute kidney injury in patients with acute exacerbation of copd.Int J COPD. 2020; 15: 1085-1092
- Contemporary trends in the management of aortic stenosis in the USA.Eur Heart J. 2020; 41: 921-928
- Trends of clinical outcomes and health care resource use in heart failure in the United States.J Am Heart Assoc. 2020; 9e016782
Published online: May 15, 2021
Received in revised form: March 20, 2021
Received: February 16, 2021
© 2021 Elsevier Inc. All rights reserved.