Factors Associated with Long-Term Hospitalization in Older Patients with Heart Failure in Japan

With the aging of the patient population with heart failure (HF), the length of hospital stay is increasing, contributing to higher healthcare costs. However, factors associated with long-term hospitalization (LTH) in older patients with HF are unknown. Therefore, the aim of the present study was to investigate these factors.Our analysis of the Kochi Registry of Subjects with Acute Decompensated Heart Failure (Kochi YOSACOI study) data of 1,061 patients with acute HF identified demographic, clinical, pre-hospital environment, and social support factors associated with LTH. A decision tree analysis was performed with the identified risk factors and using LTH as the index for risk stratification. Additionally, relationships between risk groups, length of hospital stay, and clinical outcomes were analyzed.Among 1,061 patients, 731 were included in the analysis. Among these 731 patients, 192 patients experienced LTHs (≥ 30 days). Associated factors were the Japanese version of the Cardiovascular Health Study (J-CHS) criteria score, living alone, Geriatric Nutritional Risk Index (GNRI), and systolic blood pressure at admission. Decision tree analysis categorized patients into three risk groups: low-risk (J-CHS score < 3, n = 336), medium-risk (J-CHS score ≥ 3, GNRI > 91.3, n = 395), and high-risk (J-CHS score ≥ 3, GNRI ≤ 91.3, n = 233) groups.Frailty and undernutrition were associated with LTH and worsening clinical outcomes in older patients with HF. Accordingly, the findings of this study may provide important insights into the management of older patients with HF.