Stage D heart failure in the United States: A study from a national database.

Study objective: To study the clinical characteristics and outcomes of hospitalized Stage D HF as there is paucity of data regarding this class of HF patients. Design: This is a non-interventional retrospective cohort study from a National database. Statistical analyses were conducted using STATA/MP, version 18 (StataCorp, TX). Setting and Participants: We identified all the principal hospitalizations of Stage D or End Stage HF in adults ≥18 years of old for the calendar year 2019. Main outcome measure: Characteristics, in-hospital mortality, 30-day readmissions, and causes of readmissions. Results: We identified 28,356 Stage D or End Stage HF patients, with a mean age of 66 years. 31% were females. 56% had Acute kidney injury, 5% were on hemodialysis, 51% had atrial fibrillation, 26% developed cardiogenic shock, 9% required mechanical ventilator support, and 4% sustained cardiac arrest on index hospitalization. All-cause mortality was 14% during hospitalization. The 30-day readmission rate was 7.98%, with the most common cause of readmissions being heart failure (49.78%), cardiac and vascular device-related infections (4.86%), sepsis (2.65%), acute renal failure (2.49%), and ventricular tachycardia (2.09%). 8.16% died during readmission. The mean length of stay (LOS) for the index hospitalization was 11.59 days. Conclusion: Stage D or End Stage HF poses a significant public health challenge in the United States and is associated with increased mortality, readmissions, and financial burden.