Heart Failure with Preserved Ejection Fraction in Morbidly Obese Patients is Associated with Increased Readmission Rate: Study from Large, Multicentric National Database.

Obesity paradox has been described in heart failure but data on in-hospital outcomes and readmission rates in Heart Failure with Preserved Ejection Fraction (HFpEF) in relation to body mass index (BMI) is limited. We hypothesized that mortality and readmissions would be lower in an obese population. National Readmission Database 2016 was queried for adult patients with principal discharge diagnosis of HFpEF (I50.30-I50.33) and also had ICD 10 codes for BMI listed. Patients who died during index hospitalization were excluded from readmission analysis. 87041 patients met inclusion criteria and were divided in 3 groups: Non-Obese (BMI<30), obese (BMI30-39) and morbidly obese (BMI≥40). Patients in the obese and morbidly obese group were significantly younger, African-Americans and had more co-morbidities. Acute on chronic diastolic heart failure was the most common cause of readmission in all groups but was significantly high in morbidly obese group accounting for 21.3% of all readmissions. In the non-obese and obese group, it accounted for 16.3% and 19.3% of all readmissions respectively. Sepsis was the second most common readmission diagnosis in all three groups. Acute Kidney Injury (AKI) was the third most common readmission diagnosis in obese and morbidly obese groups accounting for 5.1% and 5.7% of readmissions respectively. AKI accounted for only 3.1% of readmissions in non-obese group. HFpEF related readmissions were significantly higher in the morbidly obese group and obesity paradox was not observed for readmission rate in this cohort. In-hospital mortality was significantly high in non-obese group but length of stay (LOS) and total hospitalization charges were similar in non-obese and morbidly obese groups. In-hospital complications of AKI and readmissions due to AKI were significantly high in the obese and morbidly obese groups and needs further investigation. [ABSTRACT FROM AUTHOR]