Abstract 11494: Patient Characteristics, Management and Outcomes of Acute Heart Failure Hospitalizations in Japan

Introduction: In Japan, the prevalence of heart failure (HF) was approximately 0.8% in 2005 and is projected to increase. Yet, studies of real-world HF patients are limited. Thus, using a large multi-institutional database, we described in-hospital management and outcome of acute HF hospitalizations. Methods: We conducted a retrospective cohort study of adult patients (age ≥18) using the Medical Data Vision (MDV) database in Japan. MDV consists of ~ 35million medical records from > 400 hospitals across all regions in Japan providing data on diagnosis, procedures, pharmacy claims, and laboratory data. Acute HF hospitalizations were defined as primary HF diagnoses + use of intravenous diuretics within 48 hours. We described patient characteristics, in-hospital management, length of stay (LOS), in-hospital death, and 30-day all-cause readmissions. We included published results from AHA’s Get With The Guidelines (GWTG)-HF for benchmarking. Results: Table includes results from 120,921 hospitalizations in Japan and GWTG-HF publications. Mean age was higher but weight and BMI were lower in Japan. Laboratory values were similar but Hemoglobin A1c, B-type natriuretic peptide, and creatinine levels were lower in Japan. Mean LOS was 24 in Japan vs.4 in the US but 44% had cardiac rehab during hospitalization. In-hospital mortality was > 3 times higher but the 30-day readmission rate was lower in Japan. Conclusion: In a large multi-institutional real-world data of acute HF hospitalizations, compared to published US GWTG-HF data, Japanese patients were older but had less comorbidities. They had longer LOS and lower readmission rates. While hospital death was higher in Japan, this is not directly comparable to the US data due to the large LOS difference. Further studies to understand the reasons for the population and practice differences may generate hypotheses for potential interventions to improve HF outcomes.