Impact of nesiritide on health care resource utilization and complications in patients with decompensated heart failure.
OBJECTIVE
To determine the impact of nesiritide on health care resource utilization and complications in patients hospitalized with decompensated heart failure.


METHODS
Retrospective case-control study.


METHODS
United States hospitals.


METHODS
Two hundred sixteen patients hospitalized for decompensated heart failure.


RESULTS
One hundred eight patients who received a nesiritide infusion for a minimum of 12 hours during the first 48 hours after hospital admission were matched with 108 patients not receiving nesiritide. Health care resource utilization, consisting of hospital length of stay (LOS), rate of rehospitalization within 90 days, concomitant drugs administered, and laboratory and diagnostic tests, was determined for each hospital admission. Rates of adverse events also were recorded. Patients receiving nesiritide had a significantly shorter LOS in a critical care unit (p=0.03). General medical ward or step-down unit LOS was not different between the treatment groups. A favorable trend toward a lower rate of rehospitalization over the 90-day follow-up period was observed with nesiritide (p=0.07). The number of patients who developed life-threatening ventricular arrhythmias and hypotension was similar for both treatment groups. However, in patients receiving nesiritide, significantly less atrial fibrillation (p=0.03) and renal dysfunction (p=0.04) occurred compared with patients not receiving nesiritide.


CONCLUSIONS
Nesiritide therapy is associated with significant reductions in both health care resource utilization and complications in patients with decompensated heart failure.
Department of Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE 68131, USA.
Thomas L
TL
Lenz
Pamela A
PA
Foral
Mark A
MA
Malesker
Claire B
CB
Hunter
Daniel E
DE
Hilleman
D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000401:mortality; D016022:Case-Control Studies; D003422:Critical Care; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D008297:Male; D045283:Natriuretic Agents / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain