The Impact of Concomitant Diagnosis of Viral Infections on In-Hospital Mortality in Patients Hospitalized with a Diagnosis of Heart Failure in the United States: Insights from the National Inpatient Sample
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Baseline Characteristics and Comorbidities
3.2. Length of Stay According to Diagnosis of Viral Infection
3.3. Number of Hospital Admission for Specific Viral Infections
3.4. In-Hospital Mortality Rate and Adjusted Odds of Mortality for Specific Viral Infections
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Variable | Source | ICD-10 Code |
---|---|---|
Influenza | I10_DX1/40 | J09 *, J10 *, J11 * |
Viral pneumonia | I10_DX1/40 | J12 * |
Viral gastroenteritis | I10_DX1/40 | A08 * |
Viral meningitis/encephalitis | I10_DX1/40 | A83 *, A84 *, A85 *, A86 *, A87 *s |
Herpes simplex infection | I10_DX1/40 | B00 * |
Herpes zoster infection | I10_DX1/40 | B02 * |
Acute viral hepatitis | I10_DX1/40 | B15 *, B16 *, B17 * |
Chronic viral hepatitis | I10_DX1/40 | B18 * |
Human immunodeficiency virus | I10_DX1/40 | B20 * |
Cytomegalovirus | I10_DX1/40 | B25 * |
Parvovirus | I10_DX1/40 | B97.6 |
Adenovirus | I10_DX1/40 | B97.0 |
Enterovirus | I10_DX1/40 | B97.1 |
Respiratory syncytial virus | I10_DX1/40 | B97.4 |
Infectious mononucleosis | I10_DX1/40 | B27 * |
Viral conjunctivitis | I10_DX1/40 | B30 * |
Any virus | - | Composite of all viral infections |
Smoking (Tobacco use) | I10_DX1/40 | Z72.0 |
Alcohol misuse | I10_DX1/40 | F10.1 |
Obesity | I10_DX1/40 | E66.0, E66.1, E66.2, E66.8, E66.9 |
Hypertension | I10_DX1/40 | I10 *, I11 *, I12 *, I13 *, I15 *, I16 * |
Hyperlipidemia | I10_DX1/40 | E78.0 *, E78.1, E78.2, E78.3, E78.4 *, E78.5 |
Diabetes mellitus | I10_DX1/40 | E08 *, E09 *, E10 *, E11 *, E13 * |
Previous myocardial infarction | I10_DX1/40 | I25.2 |
Ischemic cardiomyopathy | I10_DX1/40 | I25.5 |
Dilated cardiomyopathy | I10_DX1/40 | I42.0 |
Myocarditis | I10_DX1/40 | I40 *, I41 * |
Atrial fibrillation or flutter | I10_DX1/40 | I48 * |
Valvular heart disease | I10_DX1/40 | I34 *, I35 *, I36 *, I37 * |
Infective endocarditis | I10_DX1/40 | I33 *, I38 *, I39 * |
Previous stroke | I10_DX1/40 | Z86.73, I69 * |
Peripheral vascular disease | I10_DX1/40 | I73 * |
Chronic kidney disease | I10_DX1/40 | N18 * |
Liver failure | I10_DX1/40 | K72 * |
Chronic lung disease | I10_DX1/40 | J40 *–J47 * |
Cancer | I10_DX1/40 | C00 *–C96 * |
Dementia | I10_DX1/40 | F01 *, F02 *, F03 *, G30 *, G31 * |
Immunodeficiency | I10_DX1/40 | D80 *, D81 *, D82 *, D83 *, D84 * |
Respiratory failure or arrest | I10_DX1/40 | J96 *, R09.2 |
Dependence on ventilator | I10_DX1/40 | Z99.11 |
Intubation | I10_PR1/25 | OBH17EZ |
Myocardial biopsy | I10_PR1/25 | 02BL0ZX, 02BL3ZX, 02BL4ZX, 02BK0ZX, 02BK3ZX, 02BK4ZX, 02BM0ZX, 02BM3ZX, 02BM4ZX |
Age | NIS Core | - |
Sex | NIS Core | - |
Month of admission | NIS Core | - |
Weekend admission | NIS Core | - |
Discharge weight | NIS Core | - |
Discharge disposition | NIS Core | - |
Elective admission | NIS Core | - |
Length of stay | NIS Core | - |
Primary expected payer | NIS Core | - |
Race | NIS Core | - |
Year | NIS Core | - |
ZIP income quartile | NIS Core | - |
Death | NIS Core | - |
Hospital bed size | NIS Hospital | - |
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Variable | Admission without a Diagnosis of Viral Infection (n = 19,986,859) | Admission with a Diagnosis of Viral Infection (n = 155,850) | p-Value |
---|---|---|---|
Mean age in years (±SD) | 72 ± 14 | 68 ± 14 | <0.001 |
Median age in years [IQR] | 73 [63 to 83] | 68 [59 to 80] | <0.001 |
Age group 18 to 60 years >60 to 80 years >80 years | 20.4% 48.4% 31.2% | 29.4% 46.3% 24.3% | <0.001 |
Female sex | 49.3% | 48.0% | <0.001 |
Race White Black Hispanic Asian or Pacific Islander Native American Other | 70.1% 17.4% 7.7% 2.0% 0.5% 2.2% | 61.1% 24.0% 9.1% 2.7% 0.6% 2.5% | <0.001 |
Smoking | 0.9% | 1.0% | <0.001 |
Alcohol misuse | 1.7% | 2.8% | <0.001 |
Elective admission | 9.7% | 4.8% | <0.001 |
Weekend admission | 22.7% | 25.1% | <0.001 |
Season Spring Summer Fall Winter | 25.8% 24.1% 24.6% 25.5% | 28.2% 14.8% 17.4% 39.6% | <0.001 |
Year 2016 2017 2018 2019 | 23.0% 24.5% 25.6% 26.9% | 17.9% 24.8% 29.8% 27.5% | <0.001 |
Primary expected payer Medicare Medicaid Private insurance Self-pay No charge Other | 75.7% 9.1% 11.2% 2.0% 0.2% 1.8% | 69.7% 15.7% 10.5% 2.2% 0.2% 1.7% | <0.001 |
ZIP income quartile 1st–25th 26th–50th 51st–75th 76th–100th | 32.7% 26.8% 23.0% 17.5% | 35.2% 24.9% 22.4% 17.5% | <0.001 |
Hospital bed size Small Medium Large | 20.5% 29.5% 50.0% | 18.9% 27.5% 53.5% | <0.001 |
Obesity | 22.5% | 19.1% | <0.001 |
Hypertension | 88.1% | 85.9% | <0.001 |
Hypercholesterolemia | 52.6% | 44.5% | <0.001 |
Diabetes mellitus | 47.2% | 43.8% | <0.001 |
Previous myocardial infarction | 14.9% | 12.9% | <0.001 |
Ischemic cardiomyopathy | 10.5% | 7.9% | <0.001 |
Dilated cardiomyopathy | 3.4% | 3.4% | 0.74 |
Myocarditis | <0.1% | 0.2% | <0.001 |
Atrial fibrillation | 43.9% | 37.9% | <0.001 |
Valvular heart disease | 12.2% | 9.8% | <0.001 |
Infective endocarditis | 0.7% | 1.1% | <0.001 |
Previous stroke | 15.3% | 13.4% | <0.001 |
Peripheral vascular disease | 6.5% | 5.1% | <0.001 |
Chronic kidney disease | 44.5% | 45.4% | <0.001 |
Liver failure | 1.7% | 4.0% | <0.001 |
Chronic lung disease | 40.4% | 46.6% | <0.001 |
Cancer | 7.6% | 8.7% | <0.001 |
Dementia | 11.1% | 9.3% | <0.001 |
Immunodeficiency | 0.2% | 0.5% | <0.001 |
Respiratory failure or arrest | 29.6% | 39.4% | <0.001 |
Dependence on ventilator | 0.5% | 0.7% | <0.001 |
Intubation | 4.3% | 6.8% | <0.001 |
Myocardial biopsy | 0.1% | 0.2% | <0.001 |
In-hospital mortality | 4.7% | 5.3% | <0.001 |
Mean length of stay (±SD) | 6.1 ± 7.0 | 7.5 ± 9.5 | <0.001 |
Median length of stay [IQR] | 4 [3 to 7] | 5 [3 to 9] | <0.001 |
Viral Infection | Mean Length of Stay in Days (±SD) | Median Length of Stay in Days [IQR] |
---|---|---|
Cytomegalovirus | 20.1 ± 26.9 | 11 [6 to 24] |
Viral meningitis/encephalitis | 12.9 ± 13.6 | 9 [5 to 16] |
Herpes simplex virus | 12.1 ± 13.8 | 8 [4 to 15] |
Infectious mononucleosis | 11.9 ± 13.9 | 8 [4 to 13] |
Parvovirus infection | 10.1 ± 9.3 | 7 [3 to 12] |
Adenovirus infection | 10.1 ± 12.3 | 6 [3 to 12] |
Acute viral hepatitis | 9.2 ± 10.0 | 6 [3 to 11] |
Viral pneumonia | 8.6 ± 9.9 | 6 [4 to 10] |
Herpes zoster infection | 7.7 ± 9.7 | 5 [3 to 9] |
Human immunodeficiency virus | 7.7 ± 10.9 | 5 [3 to 9] |
Viral conjunctivitis | 7.3 ± 7.2 | 5 [3 to 9] |
Chronic viral hepatitis | 7.3 ± 9.3 | 5 [3 to 8] |
Respiratory syncytial virus | 7.1 ± 8.6 | 5 [3 to 9] |
Enterovirus infection | 7.1 ± 7.0 | 5 [3 to 8] |
Influenza | 7.0 ± 7.9 | 5 [3 to 8] |
Viral gastroenteritis | 5.1 ± 6.5 | 3 [2 to 6] |
No viral infection | 6.1 ± 7.0 | 4 [3 to 7] |
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Kwok, C.S.; Abbas, K.S.; Qureshi, A.I.; Satchithananda, D.; Borovac, J.A. The Impact of Concomitant Diagnosis of Viral Infections on In-Hospital Mortality in Patients Hospitalized with a Diagnosis of Heart Failure in the United States: Insights from the National Inpatient Sample. Viruses 2022, 14, 2418. https://doi.org/10.3390/v14112418
Kwok CS, Abbas KS, Qureshi AI, Satchithananda D, Borovac JA. The Impact of Concomitant Diagnosis of Viral Infections on In-Hospital Mortality in Patients Hospitalized with a Diagnosis of Heart Failure in the United States: Insights from the National Inpatient Sample. Viruses. 2022; 14(11):2418. https://doi.org/10.3390/v14112418
Chicago/Turabian StyleKwok, Chun Shing, Kirellos Said Abbas, Adnan I. Qureshi, Duwarakan Satchithananda, and Josip Andelo Borovac. 2022. "The Impact of Concomitant Diagnosis of Viral Infections on In-Hospital Mortality in Patients Hospitalized with a Diagnosis of Heart Failure in the United States: Insights from the National Inpatient Sample" Viruses 14, no. 11: 2418. https://doi.org/10.3390/v14112418
APA StyleKwok, C. S., Abbas, K. S., Qureshi, A. I., Satchithananda, D., & Borovac, J. A. (2022). The Impact of Concomitant Diagnosis of Viral Infections on In-Hospital Mortality in Patients Hospitalized with a Diagnosis of Heart Failure in the United States: Insights from the National Inpatient Sample. Viruses, 14(11), 2418. https://doi.org/10.3390/v14112418