Heart Failure Admission Outcomes: CardioMEMS Compared

• Published in: Journal of cardiac failure Vol. 29; no. 4; p. 600
• Main Authors: Joy, Parijat S, Kumar, Gagan, Jermyn, Rita, Joseph, Susan, Shah, Chail, Afzal, Aasim, Sauer, Andrew, Alam, Amit
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2022.10.135

Implantable pulmonary artery sensor (CardioMEMS) has been shown to reduce admissions for acute heart failure (AHF). However little is known about the impact of CardioMEMS on in-hospital length of stay and in house mortality for patients admitted with heart failure hospitalizations. Compare in-hospital outcome following admission for AHF, in patients with pre-existing CardioMEMS to matched controls. Utilizing data from the National Inpatient Sample database for cases from 2016 through 2019, we identified admissions for acute heart failure (AHF) using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification (ICD-10-CM) codes for AHF. From this sample, we selected all patients who had CardioMEMS implantation before admission for AHF to constitute the ‘test’ group. For comparison, we selected, a matched ‘control’ group from AHF admissions without pre-existing CardioMEMS. The control group was selected by greedy matching based on demographic characteristics, Charlson's comorbidity index and organ failures at presentation for admission. The primary outcome compared was inpatient mortality. A total of 1,555,926 admissions for AHF were identified during the study period. Among these, 187 had CardioMEMS implanted prior to admission for AHF, who were matched to 182 controls, based on age, sex, race, Charlson's comorbidity index and presence of acute conditions at admission (cardiogenic shock, dysfunction related to hepatobiliary, neurological, metabolic, renal and respiratory systems). In-hospital mortality occurred in eleven cases (5.88%) and six (3.30%) control subjects (Odds ratio 1.40, p=0.236). Median inpatient length of stay was more for the CardioMEMS group (7 days; IQR 5-15 vs. 5 days; IQR 3-11, p = 0.0007). On adjusted analysis for the above variables, there was no significant difference of in-hospital mortality between the test and matched control groups (adjusted OR 2.17, CI 0.67-6.95, p=0.19). Once admitted for AHF, patients with CardioMEMS have similar in-hospital mortality compared and increased LOS to matched controls without CardioMEMS. Availability of pulmonary artery pressures may lead to the increased LOS in patients with CardioMEMS to optimize hemodynamics to a decongested state. Further research is needed to validate these preliminary findings.