Heart failure (HF) is a leading cause of hospitalization in the United States. Decongestion remains a central goal of inpatient management, but contemporary decongestion practices and associated weight loss are not well described. Nearly 20 years ago, the Acute Decompensated Heart Failure National Registry (ADHERE) was published and described inpatient HF treatment patterns and decongestion outcomes in a prospective national database of HF hospitalizations across 275 community and academic medical centers.
Using Truveta Data, TREAT-AHF is a national community-based cohort study that characterizes a diverse population of 262,673 patients with heart failure from 2015 to 2022, finding that the distribution of inpatient body weight change was similar to those reported from ADHERE nearly two decades ago. Discharge weight was higher than admission weight in 20% of HF hospitalizations, highlighting the challenges facing physicians and patients to effectively remove excess fluid. Furthermore, there was considerable variation in weight loss from diuretic use related to differences in patient characteristics and clinical practices. The TREAT-AHF study also demonstrated the median length of stay was 5.8 days (ranging from 3.7 to 9.7 days), which underscores the extended, variable duration of inpatient decongestion treatment. This unpredictability manifests in resource and scheduling challenges for patients, physicians and administrators.
“Reprieve is committed to understanding the ADHF patient journey. The clinical evidence from the TREAT-HF study demonstrates that heart failure decongestion management has not substantially changed in 20 years. The data highlights the opportunities to improve care, but it will take a sustained partnership among hospital systems, physicians, nurses, and industry partners to solve this. Reprieve is committed to building these partnerships,” said Mark Pacyna, chief executive officer of Reprieve Cardiovascular.