The Association Between Chronic Heart Failure and Metabolic Syndrome Increases the Cost of Hospitalization

<b>Background/Objectives</b>: This study aimed to observe and compare the real-world total hospitalization costs for patients with chronic heart failure (CHF) and metabolic syndrome (MetS) in Romania. <b>Methods</b>: Data were electronically retrieved from three different internal medicine departments of university hospitals in Bucharest, Romania, including all admissions from December 2023 to June 2024. The collected data included demographics, the cost of hospitalization (EUR), and discharge diagnoses (ICD10 codes were used to calculate the Charleston Comorbidity Index, CCI, and to define a surrogate measure for MetS). <b>Results</b>: The database query retrieved 4732 hospitalizations (median duration: 4 days; median cost: EUR 1002) of unique patients (53.9% women, average age = 68.7 years), of whom 48.0% had CHF and 11.0% were classified as having MetS. The median hospitalization duration and costs were similar for men and women, despite women being significantly older and having a higher prevalence of CHF. Patients with CHF or MetS were significantly older, had more comorbidities (CCI), and had a higher median hospitalization duration, total hospitalization cost, and cost/day than those without CHF or MetS. The total cost of hospitalization increased steadily from a minimum in patients without CHF or MetS to a maximum in patients with both conditions. <b>Conclusions</b>: CHF was highly prevalent among patients admitted to internal medicine wards and was more prevalent among hospitalized women. However, the hospitalization costs did not differ significantly between the sexes. CHF and MetS incrementally increased the total hospitalization costs in these DRG-based reimbursement systems.