P2861 - Acute Decompensated Congestive Heart Failure Outcomes in Chronic Liver Disease: Analysis Using the National In-Patient Sample

Vignesh Krishnan Nagesh, MBBS¹, Vivek Joseph Varughese, MBBS², Dominic Vacca, DO², Gowri Anil Peethambar, MBBS², Ameena Anju Jaleel, MBBS³, Mrinal Murali. Murali Krishna, MBBS⁴, Meghna Joseph, MBBS⁵, Stacy Lee, MD, MPH¹, Ayrton Bangolo, MBBS¹, Adam Atoot, MD¹, Sameh Elias, MD^1
1Hackensack Meridian Palisades Medical Center, North Bergen, NJ; ²Prisma Health, University of South Carolina School of Medicine, Columbia, SC; ³Travancore Medical College, Kollam, Kerala, India; ⁴Medical College Thiruvananthapuram, Mavelikara, Kerala, India; ⁵Medical College Thiruvananthapuram, Thodupuzha, Kerala, India

Introduction: Acute decompensated congestive heart failure (ADHF) is one of the leading causes of admissions across the United States. Aim of our study is to analyze the differences in outcomes for admissions related to ADHF with comorbid Chronic Liver Disease (CLD).

Methods: National In-Patient Sample (NIS) 2019 was used for the analysis. International Classification of Diseases (ICD) 10 codes were used to select admissions with the main diagnosis of ADHF. Prevalence of CLD in the admission cohort was calculated, and the population was stratified based on the presence of documented CLD. Further stratification was done on the basis of alcoholic and non alcoholic liver disease. Probit logistic regression was used to analyze the association between all cause mortality, length of hospital stay and hospital charges after accounting for age and other comorbidities, namely documented history of alcohol abuse, obesity, smoking, hyperlipidemia and chronic kidney disease. A two tailed p-value < 0.05 was used to determine statistical significance.

Results: We identified 4391904 admissions with the diagnosis of ADHF. In this population sample, 146050 people had coexisting unspecified CLD and 59260 of the admissions had a diagnosis of alcoholic cirrhosis. Proportion of mortality was higher for ADHF admissions with comorbid CLD when compared to ADHF admissions without the diagnosis of CLD: ADHF admissions without CLD: .045 ( .044 - .046), ADHF admissions with unspecified CLD: .054 (.052 -.057), ADHF admissions with alcoholic liver disease: .0719(.0673 -.07672). The mean of total hospital charges and length of hospital stay was also higher with statistical significance for ADHF admissions with the diagnosis of CLD when compared to regular ADHF admissions (Table 2). After regressing for age and comorbid conditions, the association between CLD and all-cause mortality in ADHF admissions remained significant: Odds Ratio: 1.390(1.318 - 1.466). Association between all cause mortality and alcoholic cirrhosis in ADHF admissions also remained significant: Odds Ratio: 1.823(1.692 - 1.963).

Discussion: Presence of CLD/alcoholic cirrhosis in ADHF admissions was associated with higher proportion of mortality, higher mean length of hospital stay and total charges. Documented diagnosis of CLD/ alcoholic cirrhosis was associated with mortality in ADHF admissions, and the association remained significant after regressing for comorbidities.


Disclosures:


Vignesh Krishnan Nagesh, MBBS¹, Vivek Joseph Varughese, MBBS², Dominic Vacca, DO², Gowri Anil Peethambar, MBBS², Ameena Anju Jaleel, MBBS³, Mrinal Murali. Murali Krishna, MBBS⁴, Meghna Joseph, MBBS⁵, Stacy Lee, MD, MPH¹, Ayrton Bangolo, MBBS¹, Adam Atoot, MD¹, Sameh Elias, MD¹. P2861 - Acute Decompensated Congestive Heart Failure Outcomes in Chronic Liver Disease: Analysis Using the National In-Patient Sample, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.