Demographics, socioeconomic factors, and in-hospital mortality predictors in patients with right heart failure

Aims Right heart failure (RHF) is associated with increased morbidity and mortality. We aimed to determine differences in baseline characteristics between survivors and nonsurvivors of index RHF admission, identify predictors of in-hospital mortality, and quantify the 30-day readmission rate. Methods We used the Nationwide Readmissions Database (NRD) from 2017 to 2020 to identify a cohort of patients with RHF, stratified by in-hospital mortality status during index admission. Baseline characteristics were compared using Pearson chi-square test and two-sample t -test for categorical and continuous variables, respectively. Multivariate analysis using logistic regression models was used to identify independent predictors of in-hospital mortality. Readmission rates within 30 days were determined by calculating the time to readmission for each patient. Results There were 12 305 (10.5%) deaths during index admission among 117 633 patients. Nonsurvivors were older (68.7 ± 14.6 years versus 66.5 ± 15.7 years) and more commonly had comorbidities such as major adverse cardiac and cerebrovascular events (MACCE), myocardial infarction, and coronavirus disease 2019 (COVID-19). The strongest predictors of in-hospital mortality (all P < 0.001) were COVID-19 [odds ratio (OR): 5.97 (5.34–6.68)], metastatic cancer [OR: 2.78 (2.52–3.06)], and myocardial infarction [OR: 1.80 (1.71–1.89)]. Over 4 years, 14.5% of index RHF admissions were readmitted within 30 days. Conclusions Our study offers insights into patients with RHF who may have a worse prognosis, highlighting the need for evidence-based management of acute and chronic RHF and consideration of advanced therapies. Interventions should be tailored to improve outcomes in RHF.