Hospitalization Period in AHF Patients Affects Prognosis after Discharge?

Background: Hospitalization of patients with acute heart failure (AHF) in Japan is extremely longer than that in Western countries. Longer stay is often due to social background rather than patient systemic status. Additionally, Japanese cardiologists tend to try to achieve complete restoration of decompensated HF to avoid rehospitalization and improve mortality after discharge. We aimed to evaluate the impact of hospital duration on clinical prognosis after discharge in patients with AHF. Methods and Results: This study included 1,070 consecutive patients who were urgently hospitalized due to AHF and discharged alive between 2013 and 2017. They were divided into 2 groups depending on a median hospital stay of enrolled patients (18.5 days); the Longer stay (n = 533) and Shorter stay group (n = 539). The primary endpoint was a combination of death from any cause and readmission due to worsening of HF. The Longer group had significantly higher BNP, lower cardiac function and poorer renal function, and were treated with higher dose of daily furosemide than Shorter group at baseline. After propensity score matching, during 275 days of median follow-up period, Kaplan-Meier analysis did not show a significant difference in the incidence of primary endpoint between the Shorter and Longer stay groups (n = 239 e.a., Log-rank: P = .97). Conclusions: Longer hospital stay did not achieve better clinical outcomes in patients with AHF after discharge alive.