Association between length of stay, frequency of in-hospital death, and causes of death in Japanese patients with acute heart failure syndromes

摘要

Neither studies nor guidelines have suggested criteria for determining the optimal length of stay (LOS) for patients hospitalized with acute heart failure syndromes (AHFS) [1] and [2]. The LOS of patients with AHFS is much longer in Japan (range of median; 18–21 days) than in Western countries (range of median; 4–10 days) because of differences in the health insurance system [3]. In fact, Japanese hospitals generally provide rehabilitation and nursing home care in addition to acute medical care for AHFS patients [3] and [4]. This suggests that the in-hospital outcome in Japan is likely to largely depend on the pathogenesis of heart failure (HF), its severity, and the quality of inpatient care rather than on factors related purely to the healthcare system. Accordingly, to investigate when and how AHFS patients actually die during hospitalization, we evaluated the association between the LOS, frequency of in-hospital death, and causes of in-hospital death in patients hospitalized for AHFS.