Association of Cancer With Outcomes in Patients Hospitalized for Heart Failure

被引:13
作者
Kaneko, Hidehiro [1 ,2 ]
Itoh, Hidetaka [1 ]
Yotsumoto, Haruki [1 ]
Kiriyama, Hiroyuki [1 ]
Kamon, Tatsuya [1 ]
Fujiu, Katsuhito [1 ,2 ]
Morita, Kojiro [3 ,5 ]
Michihata, Nobuaki [4 ]
Jo, Taisuke [4 ]
Takeda, Norifumi [1 ]
Morita, Hiroyuki [1 ]
Yasunaga, Hideo [3 ]
Komuro, Issei [1 ]
机构
[1] Univ Tokyo, Dept Cardiovasc Med, Tokyo, Japan
[2] Univ Tokyo, Dept Adv Cardiol, Tokyo, Japan
[3] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Tokyo, Japan
[4] Univ Tokyo, Dept Hlth Serv Res, Tokyo, Japan
[5] Univ Tsukuba, Fac Med, Dept Hlth Serv Res, Tsukuba, Ibaraki, Japan
关键词
Cancer; Epidemiology; Heart failure; MORTALITY; COMORBIDITY; GUIDELINES; SURVIVAL; RISK;
D O I
10.1253/circj.CJ-20-0314
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The complex clinical status of heart failure (HF) patients with concomitant cancer is gaining clinical interest. This study sought to explore the prevalence of cancer in patients with HF and its effect on outcomes using a nationwide inpatient database. Methods and Results: In total, 447,818 HF patients who were admitted and discharged between January 2010 and March 2018 were studied and included in the Diagnosis Procedure Combination (DPC) database. The median age was 81 years; 238,192 patients (53.2%) were men and 25,951 (5.8%) had concomitant cancer. The prevalence of cancer peaked in patients aged in their 70 s and 80 s and increased with time. Patients with cancer were older and more likely to be male. Cigarette smoking was more common in patients with cancer. Patients with cancer more frequently had infectious complications during hospitalization. Advanced medical procedures were less frequently performed for patients with cancer. In-hospital mortality was higher in patients with cancer than those without (10.0% vs. 6.7%, P<0.001). Among patients with cancer, in-hospital mortality was higher in patients with metastasis than those without (18.9% vs. 9.4%, P<0.001). Multivariable logistic regression analysis, fitted with a generalized estimating equation, indicated cancer is associated with higher in-hospital mortality (odds ratio 1.51, 95% confidential interval 1.43-1.59, P<0.001). Conclusions: Cancer was frequently observed in patients hospitalized for worsened HF, and its prevalence increased with time. The presence of cancer increased the risk of in-hospital death. Further studies are warranted to establish the optimal management strategy for HF patients with cancer in the field of cardio-oncology.
引用
收藏
页码:1771 / +
页数:10
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