PREVALENCE AND PREDICTORS OF MECHANICAL VENTILATION AND RESPIRATORY INTUBATION IN HEART FAILURE PRESERVED EJECTION FRACTION-RELATED HOSPITALIZATIONS

TOPIC: Critical Care TYPE: Original Investigations PURPOSE: In-hospital mortality and morbidity of heart failure preserved ejection fraction (HFpEF) patients on invasive mechanical ventilation remains high. Considering the lack contemporary evidence predictors respiratory support in this subset, we aimed to assess prevalence (MV) intubation (RI) HFpEF admissions national analysis. METHODS: We used National Inpatient Sample (October 2015-2017) requiring and/or using relevant ICD-10 diagnoses/procedure codes. assessed demographic clinical characteristics ventilator support/respiratory conducted multivariable logistic regression (OR [95% CI]) determine independent predictors. A two-sided p<0.05 was considered for a threshold statistical significance. RESULTS: Out total 4,021,773 admissions, 497,720 (74 ± 13 years) needed MV RI (12.4%). The cohort MV-RI often consisted white (73.1%), female (60%), non-elective (91.6%) admissions. had significantly higher all-cause (17.1% vs. 2.2%) less discharged routinely (22.7% 41.7%) more transferred other facilities or required home health care with median length hospital stay (8 vs 4 days) as compared those without requirement. 45-64 years group (1.26 [1.24-1.29]) ≥65 (1.04 [1.02-1.06]) odds than younger (18-44 years). Male females (1.11 [1.10-1.12]), non-white race, (1.47 [1.45-1.49]) urban/large bed size hospitals independently predicted risk HFpEF. Comorbidities including pulmonary circulation disorder (1.91 [1.87-1.95]), chronic disease (1.64 [1.63-1.66]), obesity (1.55 [1.54-1.56]), congestive (1.54 [1.53-1.56]) fluid electrolyte disorders (1.89 [1.88-1.90]) also showed requirement Pre-existing cardiovascular factors hypertension (0.87 [0.86-0.87]), diabetes (0.83 [0.82-0.83]), hyperlipidemia (0.84 [0.83-0.84] did not predict MV-RI. anemias, acquired immunodeficiency syndrome, valvular disease, depression, liver hypothyroidism were frequently associated (All p<0.001). CONCLUSIONS: healthcare resource utilization. Middle age (45-64 yrs), male sex, co-existent comorbidities CLINICAL IMPLICATIONS: Heart middle-aged males preexisting cardiopulmonary can advanced ventilatory during hospitalizations impose worse outcomes critically ill increase financial burden healthcare. Our analysis warrants screening measures vigilantly diagnose curtail high-risk improve reduce cost. DISCLOSURES: No relationships by Theresa Allagoa, source=Web Response Arashpreet Chhina, Rupak Desai, Zainab Gandhi, Vibhor Garg, YASHWITHA SAI PULAKURTHI, Priya Shenwai, Terry Went, Dwayne Wiltshire,