Medical resource use, costs, and quality of life in patients with acute decompensated heart failure: findings from ASCEND-HF.

Published

Journal Article

BACKGROUND: The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) randomly assigned 7,141 participants to nesiritide or placebo. Dyspnea improvement was more often reported in the nesiritide group, but there were no differences in 30-day all-cause mortality or heart failure readmission rates. We compared medical resource use, costs, and health utilities between the treatment groups. METHODS AND RESULTS: There were no significant differences in inpatient days, procedures, and emergency department visits reported for the first 30 days or for readmissions to day 180. EQ-5D health utilities and visual analog scale ratings were similar at 24 hours, discharge, and 30 days. Billing data and regression models were used to generate inpatient costs. Mean length of stay from randomization to discharge was 8.5 days in the nesiritide group and 8.6 days in the placebo group (P = .33). Cumulative mean costs at 30 days were $16,922 (SD $16,191) for nesiritide and $16,063 (SD $15,572) for placebo (P = .03). At 180 days, cumulative costs were $25,590 (SD $30,344) for nesiritide and $25,339 (SD $29,613) for placebo (P = .58). CONCLUSIONS: The addition of nesiritide contributed to higher short-term costs and did not significantly influence medical resource use or health utilities compared with standard care alone.

Full Text

Duke Authors

Cited Authors

  • Reed, SD; Kaul, P; Li, Y; Eapen, ZJ; Davidson-Ray, L; Schulman, KA; Massie, BM; Armstrong, PW; Starling, RC; O'Connor, CM; Hernandez, AF; Califf, RM

Published Date

  • September 2013

Published In

Volume / Issue

  • 19 / 9

Start / End Page

  • 611 - 620

PubMed ID

  • 24054337

Pubmed Central ID

  • 24054337

Electronic International Standard Serial Number (EISSN)

  • 1532-8414

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2013.07.003

Language

  • eng

Conference Location

  • United States