title: Prevalence of in-hospital nonsteroidal antiinflammatory drug exposure in patients with a primary diagnosis of heart failure.
abstract: OBJECTIVE
  To determine the prevalence of in-hospital nonsteroidal antiinflammatory drug (NSAID) exposure and associated outcomes in patients admitted with a primary diagnosis of heart failure.
  
  
  METHODS
  We performed a propensity-matched cohort analysis of patients admitted to Houston Methodist Hospital System with a primary diagnosis of heart failure according to the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) from January 1, 2011 to December 31, 2014.
  
  
  RESULTS
  Of the 9742 patients admitted with a primary diagnosis of heart failure, 384 patients (3.9%) were exposed to NSAID. After applying propensity scores we matched 305 NSAID exposed with 915 unexposed patients. Patients with in-hospital NSAID exposure had a longer length of stay (7.0±8.8 days vs 6.1±8.5; P=.003) and increased prevalence of worsening renal function (34.4% vs 27.9%; P=.030). There were not statically significant differences in in-hospital mortality rate or 30-day all-cause readmission rate.
  
  
  CONCLUSIONS
  Exposure to NSAID in patients admitted with a primary diagnosis of heart failure was low but was associated with adverse outcomes including longer length of stay and higher prevalence or worsening renal function.
authors.affiliation: Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Paulino A
authors.identifier: http://orcid.org/0000-0001-9272-9605
authors.initials: PA
authors.lastname: Alvarez
authors.affiliation: Department of Pharmacy, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: David
authors.initials: D
authors.lastname: Putney
authors.affiliation: Department of Informatics Development, Houston Methodist Corporate, Houston, TX, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Ogunti
authors.affiliation: Department of Informatics Development, Houston Methodist Corporate, Houston, TX, USA.
authors.forename: Mamta
authors.initials: M
authors.lastname: Puppala
authors.affiliation: School of Public Health, University of Texas, Houston, TX, USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Ganduglia
authors.affiliation: Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Torre-Amione
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Schutt
authors.affiliation: Department of Informatics Development, Houston Methodist Corporate, Houston, TX, USA.|Department of Systems Medicine and Bio-engineering, Houston Methodist Research Institute, Houston, TX, USA.
authors.forename: Stephen T C
authors.initials: STC
authors.lastname: Wong
authors.affiliation: Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Estep
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Acute kidney injury; Antiinflammatory agents; Heart failure; Length of stay; Nonsteroidal; Patient readmission; Pharmacoepidemiology