血管医学および外科ジャーナル

概要

Lower Extremity Deep Vein Thrombosis is Associated with Mortality among Patients Hospitalized with Congestive Heart Failure: Results from the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample (1998-2007)

Oluwaseyi Bolorunduro, Sunday Olatunde, Avtar Singh, Mohammed Amer, Olakunle Akinboboye and Edgar Lichstein

Introduction: About 5.8 million patients suffer from Heart failure in the United States and this number is expected to be on the rise. These patients have been shown to be at increased risk of developing Deep Vein Thrombosis (DVT). We analyzed 10 years of data from a nationwide database of inpatients to compare the outcomes of heart failure in patients with and without DVT. Methods: A retrospective analysis was conducted using data from the Nationwide Inpatient Sample (NIS) from 1998 to 2007(10 years). All Adult patients (above 18 years old) with Heart failure during this period were identified using ICD 9 codes. Baseline characteristics and outcomes of heart failure patients with documented DVT vs. without DVT were compared during the incident admission. Multivariate regression for mortality was conducted, controlling for age, gender, and the presence of co-morbidities. Another multivariate analysis was conducted to determine predictors of developing DVT in this population of heart failure patients. Results: Among 7,880,500 patients managed for Heart failure in this database during the study period, patients with DVT were more likely to have been older than those without DVT (p<0.01). They were noted to have had longer LOS {Median LOS 5 (IQR 3-8) vs. 8 (IQR 5 -13) days} and higher mortality rates (9.3 vs. 6.9% p values<0.01). On multivariate regression heart failure patients with DVT were 38% more likely to die than those without DVT after controlling for other co-morbidities (OR 1.38 p<0.01). Conclusion: Deep vein thrombosis is associated with mortality among heart failure patients. Also increasing length of hospital stay in this population was noted to be associated with higher DVT rates.