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Published in: BMC Cardiovascular Disorders 1/2007

Open Access 01-12-2007 | Research article

Outcomes of patients hospitalized for acute decompensated heart failure: does nesiritide make a difference?

Authors: Richard J Carroll, Zuber D Mulla, Loran D Hauck, Audrey Westbrook

Published in: BMC Cardiovascular Disorders | Issue 1/2007

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Abstract

Background

Nesiritide is indicated in the treatment of acute decompensated heart failure. However, a recent meta-analysis reported that nesiritide may be associated with an increased risk of death. Our goal was to evaluate the impact of nesiritide treatment on four outcomes among adults hospitalized for congestive heart failure (CHF) during a three-year period.

Methods

CHF patients discharged between 1/1/2002 and 12/31/2004 from the Adventist Health System, a national, not-for-profit hospital system, were identified. 25,330 records were included in this retrospective study. Nesiritide odds ratios (OR) were adjusted for various factors including nine medications and/or an APR-DRG severity score.

Results

Initially, treatment with nesiritide was found to be associated with a 59% higher odds of hospital mortality (Unadjusted OR = 1.59, 95% confidence interval [CI]: 1.31–1.93). Adjusting for race, low economic status, APR-DRG severity of illness score, and the receipt of nine medications yielded a nonsignificant nesiritide OR of 1.07 for hospital death (95% CI: 0.85–1.35). Nesiritide was positively associated with the odds of prolonged length of stay (all adjusted ORs = 1.66) and elevated pharmacy cost (all adjusted ORs > 5).

Conclusion

In this observational study, nesiritide therapy was associated with increased length of stay and pharmacy cost, but not hospital mortality. Randomized trials are urgently needed to better define the efficacy, if any, of nesiritide in the treatment of decompensated heart failure.
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Metadata
Title
Outcomes of patients hospitalized for acute decompensated heart failure: does nesiritide make a difference?
Authors
Richard J Carroll
Zuber D Mulla
Loran D Hauck
Audrey Westbrook
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2007
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-7-37

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