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.

背景：心力衰竭（HF）患者并发癌症的复杂临床状态正在引起临床兴趣。本研究试图使用全国住院患者数据库探索 HF 患者癌症的患病率及其对结果的影响。

方法和结果：总共研究了 2010 年 1 月至 2018 年 3 月期间入院和出院的 447,818 名 HF 患者，并将其纳入诊断程序组合 (DPC) 数据库。中位年龄为 81 岁；238,192 名患者 (53.2%) 为男性，25,951 (5.8%) 名患者同时患有癌症。癌症的患病率在 70 多岁和 80 多岁的患者中达到顶峰，并随着时间的推移而增加。癌症患者年龄较大，而且更可能是男性。吸烟在癌症患者中更为常见。癌症患者在住院期间更常出现感染并发症。对癌症患者进行高级医疗程序的频率较低。癌症患者的院内死亡率高于无癌症患者（10.0% vs. 6.7%，P<0.001）。在癌症患者中，有转移患者的院内死亡率高于无转移患者（18.9% vs. 9.4%，P<0.001）。符合广义估计方程的多变量逻辑回归分析表明癌症与较高的院内死亡率相关（比值比 1.51，95% 保密区间 1.43–1.59，P<0.001）。

结论：在因心衰恶化住院的患者中经常观察到癌症，并且其患病率随着时间的推移而增加。癌症的存在增加了院内死亡的风险。需要进一步研究以在心脏肿瘤学领域为患有癌症的 HF 患者建立最佳管理策略。