Abstract 4148170: Impact of cancer on healthcare utilization in patients with heart failure

Background: Cardiovascular disease is an important cause for mortality in cancer patients and cancer is a primary cause of non- cardiac mortality in patients with heart failure. With an estimated 17 million cancer survivors in the US, with numbers only expected to increase and a projected 8 million heart failure patients by 2030, these diseases have a tremendous impact on healthcare costs. The aim of this study is to determine the hospital resource utilization in patients with heart failure and cancer. Methods: This is a retrospective cohort study using the Agency of Healthcare Research and Quality’s National Readmission Database (NRD) for the year 2019. Patients with a principal discharge diagnosis of heart failure were stratified into two groups based on presence of cancer. Weighting of patient level observations was implemented to obtain national level estimates. The primary outcome was 30-day all-cause hospital readmission. The secondary outcomes analyzed were 30- day mortality rate, mean length of stay and mean cost of hospitalization. The five most common causes of readmission were also determined. Results: 53, 219 weighted heart failure hospitalizations had cancer, while 996,566 did not have cancer. Patients with cancer had a significantly higher rate of 30-day readmission rate (25.6 % vs 22.1%; OR: 1.22; p <0.05). Patients with cancer also had a higher 30-day mortality rate (5.7% vs 3.1%; OR: 1.6; p <0.05), longer length of stay (6.14 vs 5.6 days; p <0.05) and higher hospitalization costs ($ 15,191 vs $14,013; p < 0.05). More than one third of readmissions were due to heart failure. Conclusion: Among patients with heart failure, a co-existing diagnosis of cancer is associated with increased 30-day readmission rate, increased 30-day mortality, longer length of stay and higher hospitalization costs.