Increasing Rate of Hospital Admissions in Patients With Amyloidosis (from the National Inpatient Sample)

Cardiac amyloidosis is an increasingly recognized cause of heart failure with preserved or mildly reduced ejection fraction with emerging treatment options. We sought to analyze the temporal trends and impact of hospital admissions in patients with amyloidosis. The National Inpatient Sample was queried to identify patients from 2005 to 2014 who were hospitalized with a diagnosis of amyloidosis using ICD9 codes. Trends over time of prevalence, demographics, co-morbidities, and outcomes were described. Propensity-matching was used to assess the impact of amyloidosis on in-hospital outcomes, including mortality. A total of 156,914 admissions in patients with amyloidosis (age 69.86 +/- 12.33 years, 45.7% female, 68.5% Caucasian) were identified. Hospitalizations more than doubled with a peak of 21,740 per year and 62 per 100,000 admissions in 2014. Over time, patients admitted with amyloidosis were older and more likely to have co-morbid medical conditions. A diagnosis of heart failure was present in 34.7% of patients, increased over time (p = 0.001), and was associated with further morbidity and mortality. In a propensity-matched analysis, patients admitted with amyloidosis had a longer length of stay (7.5 vs 6.2 days), were less likely to be discharged home (43.6% vs 48.7%), and were more likely to die during the hospitalization (7.4% vs 4.9%, p <0.001 for all). In conclusion, inpatient hospitalizations in the United States in patients with amyloidosis have increased over time and are associated with high morbidity and mortality, particularly when there is concomitant heart failure. (C) 2019 Elsevier Inc. All rights reserved.