Key result
Early tolvaptan is linked to shorter hospital stays versus delayed administration in elderly ADHF patients.
Why the study?
Long hospital stay is associated with high costs and poor quality of life in elderly patients with heart failure, prompting investigation into whether early tolvaptan reduces stay length.
Does early tolvaptan administration reduce length of hospital stay in elderly patients with acute decompensated heart failure?
Cohort
No
Does early tolvaptan administration reduce length of hospital stay in elderly patients with acute decompensated heart failure?
p-value: p=<0.001
Early administration of tolvaptan within 24 hours of admission may reduce the length of hospital stay in elderly patients with acute decompensated heart failure.
May shorten stay in elderly ADHF; hypothesis-generating and requires RCT confirmation before practice change.
Introduction: Long hospital stay is associated with high costs and poor quality of life in elderly patients with heart failure (HF). This study aimed to investigate the association of early administration of tolvaptan with length of hospital stay among elderly patients with HF. Methods: The cohort included elderly patients (age ≥ 75 years) admitted to Shinonoi General Hospital between July 2016 and December 2018 with a primary diagnosis of acute decompensated HF treated with tolvaptan. Patients who died during hospitalization, patients who had acute coronary syndrome, patients who required treatment in the intensive care unit, and patients who had already taken tolvaptan before admission were excluded. Patients were divided into two groups according to the median duration of admission to tolvaptan administration: those who received tolvaptan within 1 day (24 h) after admission (early treatment group) and those for whom tolvaptan was prescribed after 1 day (24 h) or more from hospitalization (add-on group). We compared the length of hospital stay between the two groups and investigated the relationship between early tolvaptan administration and length of hospital stay. Results: = 0.564, p < 0.001). Conclusions: Early tolvaptan administration was associated with reduced length of hospital stay in elderly HF.
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Suzuki et al. (2024) conducted a cohort in Acute decompensated heart failure. Early tolvaptan administration (within 24 hours of admission) vs. Tolvaptan administration after 24 hours of admission (add-on group) was evaluated on Length of hospital stay (p=<0.001). Early tolvaptan administration within 24 hours of admission was associated with a reduced length of hospital stay in elderly patients with acute decompensated heart failure (p < 0.001).
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