Abstract 13973: Amyloidosis and Heart Failure is a Deadly Combination: A Retrospective Study From 2015-2019 Using the National Inpatient Sample

Introduction: Heart failure (HF) is a common cause of hospitalization in the United States. Amyloidosis has become a more accepted cause of HF in the US however contemporary data on amyloidosis affecting the heart is relatively lacking even in the setting of increased mortality and morbidity rates. This study is aimed to define the prevalence of HF in amyloidosis along with looking at inpatient mortality, length of stay and other relevant factors.

Methods: For the current study, the National Inpatient Sample (NIS) was queried for the years 2015 Q4-2019. Our cohort of interest included patients with amyloidosis. We further identified patients with heart failure using the ICD-10 diagnosis codes algorithm for Elixshauser comorbidity scoring.

Results: A total of 23,586 patients were identified with amyloidosis between 2015 Q4 and 2019. Interestingly, 49% of those patients (11,560 people) were identified with a diagnosis of HF, reflecting its increased prevalence in patients with amyloidosis. The mean age of the cohort was 71.9 years (SD=12.3), Patients with heart failure were overall more likely to be males (63.7% vs 50.2%, p<0.001), and were more likely to be African American (30.4% vs 16.2%, overall p<0.001), compared to patients without heart failure. When compared to amyloidosis subjects without HF, those with HF experienced an increased rate of mortality (7.2% vs 5.5%, p<0.001), a longer length of stay (LOS) with a mean difference of 0.7 days (7.9 days vs 7.2 days, p<0.001), and a more costly overall hospitalization with a mean difference of $10,906.1 ($90159.3 vs $79253.2, p<0.001). Upon multivariable logistic regression analysis, the presence of HF (OR 1.24, 95%CI 1.11-1.401, p<0.001) was associated with higher odds of in-hospital mortality.

Conclusions: Our study shows that HF is a dominant comorbidity in patients with amyloidosis with almost every other patient being affected. Additionally, when compared to those without HF, patients with HF were more likely to be African American, have a longer length of stay, have more costly admissions, and overall had a higher rate of in-patient mortality.