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.
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Article info
Publication history
Published online: May 15, 2021
Received in revised form:
March 20,
2021
Received:
February 16,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
