Abstract

Objectives

Breast cancer and heart failure (HF) are frequently interconnected due to shared risk factors and the cardiotoxicity of breast cancer treatment. However, the association between HF and hospital outcomes among breast cancer patients has not been studied. This study examined the association between HF and hospital outcomes among hospitalized patients with breast cancer.

Methods

This cross-sectional study using the 2015–2018 Healthcare Cost and Utilization Project–National Inpatient Sample data included hospitalized women who were aged 18 years or older and had a primary diagnosis code for breast cancer. Logistic regression, negative binomial regression, and generalized linear models with log-link and gamma distribution were used to assess the associations of HF with in-hospital mortality, length of stay (LOS) and hospital costs.

Results

Among 17,335 hospitalized patients with breast cancer, 4.2% (n = 1021) had HF. Compared to breast cancer patients without HF, those with HF were more likely to die during hospitalization (odds ratio = 1.65, 95% CI = 1.27–2.16, p < .001), stay in the hospital longer (incidence rate ratio = 1.22, 95% CI = 1.15–1.30, p < .001) and have higher hospital costs (cost ratio = 1.09, 95% CI = 1.03–1.14, p = .003) during hospitalization, controlling for covariates.

Conclusion

HF has a substantial negative impact on health outcomes among hospitalized breast cancer patients. Breast cancer and HF are often considered separate medical conditions, but promoting effective management of comorbid HF in breast cancer patients may help to improve hospital outcomes in this population.

中文翻译：

---

美国合并心力衰竭住院乳腺癌患者的住院死亡率、住院时间和住院费用

 抽象的

 目标

由于共同的危险因素和乳腺癌治疗的心脏毒性，乳腺癌和心力衰竭 (HF) 经常相互关联。然而，尚未研究乳腺癌患者心衰与医院结局之间的关联。本研究探讨了住院乳腺癌患者心力衰竭与医院结局之间的关联。

 方法

这项横断面研究使用 2015-2018 年医疗保健成本和利用项目 - 全国住院患者样本数据，包括年龄 18 岁或以上且具有乳腺癌主要诊断代码的住院女性。使用 Logistic 回归、负二项式回归以及具有对数链接和伽玛分布的广义线性模型来评估心力衰竭与院内死亡率、住院时间 (LOS) 和医院费用的关联。

 结果

在 17,335 名住院乳腺癌患者中，4.2%（ n = 1021）患有心力衰竭。与没有心力衰竭的乳腺癌患者相比，心力衰竭患者在住院期间死亡的可能性更大（优势比 = 1.65，95% CI = 1.27–2.16， p < .001），住院时间更长（发病率比 = 1.22，控制协变量后，住院期间 95% CI = 1.15–1.30， p < .001）且住院费用较高（费用比 = 1.09，95% CI = 1.03–1.14， p = .003）。

 结论

心力衰竭对住院乳腺癌患者的健康结果有重大负面影响。乳腺癌和心力衰竭通常被认为是不同的医疗状况，但促进乳腺癌患者合并心力衰竭的有效管理可能有助于改善该人群的医院预后。