Brief summary
Background
Methods
Study protocol
Information sources and literature search
Study Characteristics | Type, n |
---|---|
Journal disciplines | Peer-reviewed or double blind, n = 34 Dissertations, n = 2 |
Grey Literature (n = included/potentially eligible) | CADTH- Canadian Agency for Drugs and Technologies in Health n = 0/15 |
Center for Disease Control n.ra. | |
CIHI n.r. | |
Health Canada n = 0/9 | |
Google Scholar n = 1/491 | |
TRIP n = 1/19 | |
National Technical Information Service n = 1/581 | |
Scopus n = 1/10 | |
Duck Duck Go n = 2/200 | |
UofT Theses and Dissertations in the Sciences n = 0 | |
OAIster n = 0/2 | |
Health Quality Ontario, n = 0/5 | |
New York Academy of Medicine’s Grey Literature Report n = 0 | |
Open Grey n = 0/4 | |
T-space n = 0/31 | |
World Health Organization n.r. | |
Consultation Experts | Journal Articles 1/7 (exclusion criteria: did not address re-admission) |
Study Design | Prospective n = 11 |
Retrospective n = 25 | |
Year of publication | 2013–2017 n = 14 |
2008–2012 n = 13 | |
2002–2007 n = 9 | |
Geographical region | North America (US n = 14, Canada n = 4) |
Europe n = 11 | |
Asia n = 4 | |
Australia n = 2 | |
Africa n = 1 |
Eligibility criteria
Study selection process
Data items and data abstraction process
Definition of sex and gender
Results
Article types
Clinical aims
Definition of heart failure
Primary Author (Year of Publication) | Definition of heart failure |
---|---|
World Health Organization’s International Classification of Diseases code-10th revision; 9th revision; Australian modification | |
European Society of Cardiology | |
Confirmed by a cardiologist, using standard Framingham criteria or exacerbation of a previously documented HF; Framingham criteria (including symptoms, physical examination, chest x-ray and echocardiographic findings) | |
Vader (2016) [46] | The presence of more than one symptom (dyspnea, orthopnea, edema) and 1 sign (rales on auscultation, peripheral edema, ascites, or pulmonary vascular congestion on chest radiography) in DOSE-AHF or ROSE-HF or admission to the hospital with a primary diagnosis in CARRESS HF |
Gevaert (2014) [47] | Preserved left ventricular fraction was defined as left ventricular ejection fraction greater than or equal to 50% and heart failure with reduced ejection fraction was defined as less than 50% |
Chang (2014) [48] | New onset of HF with acute decompensation or chronic HF with acute decompensation requiring hospitalization |
Alla (2007) [49] | Current or past evidence of low cardiac output or congestion edema, elevated jugular venous pressure, or rales or evidence of pulmonary congestion |
Ieva (2015) [50] | Diagnostic Category - Nervous system, respiratory system, circulatory system, with HF-related events, from Agency for healthcare research and quality and centres for Medicare and medicaid services hierarchical condition category in hospital administrative database |
Tarantini (2002) [51] | Hospital admission for CHF |
Zsilinskza (2016) [52] | Heart Failure National Registry Emergency Module (ADHERE-EM) database |
Sajeev (2017) [45] | Chronic systolic HF was defined as systolic HF for at least 6 months with an EF of less than 50% and/or patients who are on standard HF medications, which include at least two groups of medications mentioned: ACEI/ARB, diuretics or digoxin |
Nieminen (2008) [53] | Diastolic dysfunction was classified by the investigator as mild, moderate or severe according to echocardiographic criteria; signs of heart failure (rales, hypotension, hypoperfusion) and signs of heart failure on chest x-ray. Acute decompensated chronic heart failure was defined as worsening of heart failure in patients with a previous diagnosis or hospitalization for heart failure or as new-onset acute heart failure for patients with no prior history of heart failure |
Mullens (2008) [54] | Impaired cardiac output (cardiac index < 2.4Lmin/m2) |
Not reported; Diagnosis of HF made by a specialist (cardiologist and/or internist) |
Outcomes reported
Primary Author (year) | Objectives | Study Population (interventions) | Study Setting (geographical location, recruitment period) | Study Design | Study Endpoints |
---|---|---|---|---|---|
Arora (2017) [26] | To evaluate specific etiologies, trends and predictors of 30-day readmission in patients admitted with HF from one of the largest nationwide databases | Patients with heart failure. Besides Medicare, also included Medicaid, private/health maintenance organization and self-pay patients. | 2013; all-payer inpatient database in US | Retrospective cohort design | 30-day readmissions; with and without HF |
Gevaert (2014) [47] | To compare the incidence and treatment of atrial fibrillation on admission between men and women admitted with acute heart failure | Patients included in the prospective BIO-HF registry (evaluate all patients admitted with the New York Heart Association class 3–4) | 2 Belgian hospitals, Nov 2006 to May 2012; Patients included in the prospective BIO-HF registry (evaluates all patients admitted with the New York Heart Association class 3–4) | Prospective design | One-year all-cause mortality or readmission for HF. Secondary endpoints were in-hospital mortality and restoration of sinus rhythm at discharge |
Howie-Esquivel (2007) [42] | To determine whether demographic, clinical, or psychological variables conferred increased risk of rehospitalization in a multiethnic, hospitalized heart failure population 90 days after hospitalization for heart failure | Patients with HF, English or Korean | Large academic medical center in Northern California, data collected from July 2004 to April 2005 | Prospective cohort study | Quality of life, mean discharge brain natriuretic peptide; 6MWT distance, rehospitalizations |
Jimenez-Navarro (2010) [38] | To determine the influence of gender on the diagnostic and therapeutic management and long-term prognosis of patients with heart failure seen in specific heart failure clinics | Patients with chronic heart failure. 21% patients were from community hospitals and 79% from the general hospitals. | 62 Centers incl. 14 (22%) community hospitals and 48 (78%) general hospitals; 10 (16%) of the participating hospitals have a heart transplantation program. 8 (13% of the total) depend on an internal medicine service. Heart failure units or clinics (Spain, 2000 to 2003) | Retrospective observational multicenter study | Mortality, admissions for heart failure, acute myocardial infarction, coronary revascularization, valvular surgery, or heart transplant |
Macdonald (2008) [25] | To assess the association of diabetes with short and long-term outcomes in all patients hospitalized for the first time with heart failure in Scotland | Individuals discharged from hospital with a diagnosis or heart failure according to history of diabetes and sex | Hospitals (Scotland, 1986 to 2003) | Retrospective cohort study | Combined end point of death or HF readmission, also separately reported per males and females |
Vader (2016) [46] | Characterized the risk factors for post discharge readmission/death in subjects treated for acute heart failure | Patients hospitalized with acute heart failure | From 3 different trials | Post hoc retrospective analysis | Rehospitalization or death after discharge from the index hospitalization analyzed in a continuous fashion or in the intervals of 0–30 days or 31–60 days |
Primary author (year) | Sample Size n (%) | Mean Age (years) | Mean Length of Hospital Stay (days) | Type of Reporting by Sex1 | Time to Event (months), Heart Failure Readmission Rate | Other | Significance | |
---|---|---|---|---|---|---|---|---|
Female | Male | |||||||
Arora (2017) [26] | 301,892 F: n (49.4) M: n (50.6) | 73.4% ≥ 65 years | 5.29 ± 0.01 | b, c | 1-month, 0.93 OR (0.90–0.96) | Female readmission without HF: 1.02 OR (1.00–1.05) | Females | |
Gevaert (2014) [47] | 957; F:435(44.5); M: 542 (55.5) | F < 75 years (42.5) vs. (20.3) M, p = 0.005 | b,c | 12 | Mortality and hospitalization: Adj. OR for female gender:1.1 (0.65–1.86) Prognosis women < 75 years of age: 7.17 OR (1.79–28.66) | Females, less than 75 years of age, prognosis | ||
Howie-Esquivel (2007) [42] | 72; M: 47 | 62 ± 18 | 34 were rehospitalized for cardiac reasons within 3 months. Women had a 2.5 times greater risk for rehospitalization than men. 52 days; 40 days non-Caucasian females; > 90 days in males | Women had a 2.5 times greater risk for rehospitalization than men. Non white ethnicity and female gender incurred ≥2 times greater risk of cardiac rehospitalization | ||||
Jimenez-Navarro (2010) [38] | Females, 1368 (29) Males, 3351 (71) | Females 64 ± 12, p < 0.001 Males 70 ± 12 | a, b, c | 40 ± 12, 60% not require readmission | 77% not require readmission | Cardiovascular event-free survival: F, 45%, M, 62% | Females higher in heart failure readmission and lower cardiovascular event-free survival, P < 0.001 | |
Macdonald (2008) [25] | With Diabetes, 15,161 Females, 7805 Males, 7356 | Females With Diabetes 73.8 ± 10.0 Males with Diabetes 70.0 ± 10.3 | a, b, c | 1-month, Diabetic Crude Rate 7.1 (6.5–7.7) 1-month, Non Diabetic Crude Rate 5.2 (5.0–5.4) | 8.4 (7.7–9.1) 6.8 (6.5–7.0) | Women younger than 65 at both 1 and 5 years have a greater risk for heart failure readmission or death associated with diabetes than in men younger than 65 years and women older than 75 years. | Females < 75 years of age with diabetes | |
Without Diabetes, 101,395 Females, 53,578 Males, 47,817 | Females without Diabetes 77.3 ± 11.5 Males without Diabetes 71.8 ± 12.4 | 12-month, Diabetic Crude Rate 38.0 (36.7–39.3) | 38.9 (37.5–40.2) | |||||
12-month, Non Diabetic Crude Rate 29.1 (28.6–29.6) | 31.2 (30.7–31.7) | |||||||
60-Month, Diabetic Crude Rate 69.8 (68.3–71.3) | 70.2 (68.7–71.7) | |||||||
60-Month, Non Diabetic Crude Rate 57.6 (57.0–58.2) | 58.8 (58.2–59.4) | |||||||
Vader (2016) [46] | F: 185 (24.9); M:559 (75.1) | 69 (60–78) | 6 | b,c | 1,2 | 0.74 (0.57–0.98) | Male is lower in readmission or death |
Primary Author (year) | Objectives | Study Population (interventions) | Study Setting (geographical location, recruitment period) | Study Design | Study Endpoints |
---|---|---|---|---|---|
Alla (2007) [49] | To investigate the association of sex with the risk of adverse events, especially hospitalization for heart failure. To evaluate the association between sex and the risk of mortality and hospitalization, not only for worsening heart failure but other causes, across the clinical syndrome of heart failure. | Patients with clinical heart failure | 302 clinical centers (United States and Canada, February 1991 to September 1993) | Retrospective design | All-cause mortality and hospitalization for worsening heart failure, and secondary end points included all-cause hospitalization and cardiovascular hospitalization. |
Blackledge (2003) [31] | To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome | Patients newly admitted with heart failure | UK district health authority (April 1998 to March 2001) | Historical cohort study | Death from any cause (all cause survival) and all cause survival or emergency readmission for a cardiovascular event (event free survival) |
Goncalves (2008) [39] | To determine the prognostic value of left ventricular systolic function and identify prognostic indices in patients hospitalized due to HF with preserved and depressed LVSF | Admitted due to decompensated HF | 18 months between October 2002 and April 2004, admitted to the Internal Medicine Department | Retrospective design | Primary endpoint was all-cause death or readmission within 6 months |
Howlett (2009) [28] | To determine the effectiveness of HF clinics in reducing death or all-cause rehospitalization in a real-world population | Patients with a diagnosis of heart failure | 4 heart failure clinics (Nova Scotia, Canada, October 1997 to July 2000) | Retrospective | The primary end point – combined all-cause mortality and hospitalization at the one-year follow-up. Secondary outcomes included the one year total mortality and all-cause hospital readmission rate. |
Islam (2013) [58] | Examine demographic and clinical characteristics of patients with CHF who are 65 years of age or older and are and are not readmitted to hospital within 28 days of discharge from an index admission | Older patients with CHF | A large metropolitan public health service (Melbourne, Australia. June 2006 to June 2011) | Retrospective Comparative cohort | Hospital readmission within 28 days |
Ieva (2015) [50] | To demonstrate a flexible approach that is able to capture important features of disease progression, such as multiple ordered events and the competing risks of death and hospitalization | Patients with heart failure | Administrative database (Italy, 2000–2010) | Retrospective design | Hospital admissions and death |
Madigan (2012) [29] | To determine patient, home health care agency, and geographic (i.e., area variation) factors related to 30-day rehospitalization in a national population of home health care patients with heart failure, and to describe the extent to which rehospitalizations were potentially avoidable | Home health care patients with heart failure | All home care whose care was paid for by the traditional Medicare fee-for-service program (USA, 2005) | Retrospective design | 30-day rehospitalization rate |
Nieminen (2008) [53] | To evaluate the gender differences in patients hospitalized for acute heart failure in the EuroHeart Failure Survey II | Patents with dyspnoea and verified heart failure | 133 Hospitals: university hospitals 47, 49% community or district hospitals, 4% private clinics (30 European countries, October 21st 2004 to August 31st 2005) | Prospective | Gender differences in prescription of HF medication; rehospitalizations and one-year mortality |
Ogah (2014) [40] | Examine the rate and predictors of hospital readmission in patients discharged after an episode of heart failure | Patients with heart failure | Private / public primary and secondary health care facilities (Abeokuta, Nigeria, January 2009 to December 2010) | Prospective Study | Hospital readmission |
Omersa (2016) [27] | To analyze the readmissions during or following the first HF hospitalization in patients aged 65 years or over, and to evaluate the prevalence of comorbidities and their prognostic implications in terms of mortality and readmission. | Patients aged 65 years or over who had first heart failure hospitalization | Hospitals (Slovenia, 2008–2012) | Retrospective Observational | All cause mortality and readmission within 30 days, and 1 year after discharge from first HF hospitalization |
Robertson (2012) [30] | To assess the typical profile, trajectory and resource use of a cohort of Australian patients with heart failure using linked population based, patient-level data | Residents aged ≥45 years with a first (index) admission for heart failure | Admitted Patient Data Collection (New South Wales, Australia, July 2000 to June 2007) | Retrospective Cohort Study Registry | Hospital readmission |
Sato (2015) [43] | To compare prognostic risk factors between older and younger chronic heart failure patients | Patients admitted for treatment of worsening CHF | Patients admitted to Fukushima Medical University Hospital, July 2006 and May 2012 | Prospective | Cardiac death (death as a result of heart failure and sudden cardiac death) or re-hospitalization as a result of worsening heart failure |
Primary Author (year) | Sample Size n (%) | Mean Age (years) | Type of Reporting by Sex1 | Time to Event (months) | Heart Failure Readmission Hazard Ratio | Death and/or Hospital Readmission Ratio | Other | Significance |
---|---|---|---|---|---|---|---|---|
Alla (2007) [49] | F:1517 LVD, 407 PEF M: 5273 LVD, 581 PEF | F: 65 ± 12LVD, 69 ± 11PEF; M: 63 ± 11 LVD, 66 ± 9.7 | a,b,c | 35 | Adjusted men vs. women 1.17 (1.06–1.29) | Mortality: Adjusted men vs. women 1.47 (1.33–1.63) All-Cause: Adjusted men vs. women 1.18 (1.11–1.27); Cardiovascular Readmission: Adjusted men vs. women 1.12 (1.04–1.21); When ejection fraction was reduced, 1.19 HR (1.07–1.33) but not preserved HR 0.90: 0.67–1.22 | Males, All Cause and lower survival | |
Blackledge (2003) [31] | F:2913 (50); M:2876 (50) | 41–107 | b, c | n.r | 0.92 (0.85–0.98) | Mortality: 0.88 (0.82–0.96) | Males, Death and/or Hospital readmission and lower survival | |
Goncalves (2008) [39] | F(54.3); preserved LVSF F(72.9),M(26 (27.1); depressed LVSF F (45), M (113, 54.3) | 72.7 (1.6); preserved LVSF 73.3 ± 11.2 vs. depressed LVSF 70.7 ± 12.7, p = 0.13 | b, c | 6 | M preserved LVSF 2.04 (1.08–3.84); M Depressed LVSF 0.64 (0.42–0.96) | Males with preserved and depressed LVSF, Death and/or hospital readmission | ||
Howlett (2009) [28] | F:364(37), M:620 (63) | 68 ± 13 | b,c | 12 | 1.21 (1.06–1.37) | Males, death and/or hospital readmission | ||
Islam (2013) [58] | F:313 (49.7), M:317 (50.3) | 65–74:22.4 75–84:47.6 85+:30.0 | b, c | n.r. | All Cause Readmission: 1.22 (1.03–1.46) | Males, All Cause | ||
Ieva (2015) [50] | F:8114 (53.04), M:7184 (46.96) | F:79.6(11.4), M:71.5 (12.88) | a, b | n.r. | n.r. | Males | ||
Madigan (2012) [29] | F:45429 (61) | c | 1 | All Cause Readmission: 1.079 (1.047, 1.112) | Males, All Cause | |||
Nieminen (2008) [53] | 3580, F: 1384 (29); M:2916(61) | F: 73.1 ± 12.0, p < 0.001; M: 67.8 ± 12.4 | a,b,c | 3,12 | Mortality: 1.04 (0.79–1.37); All-Cause Readmission: Age-adjusted, 0.84 (0.74–0.96); Event-free survival: Death, myocardial infarction or stroke, 10.1: 9.7; 0.95 (0.76–1.20) | Males, All Cause | ||
Ogah (2014) [40] | F: 124(47), M 138 (53); rehospitalized m 21 (65.6); not hospitalized m 117 (50.9) | Readmitted 61.7 ± 14.0 vs non readmitted 56.1 ± 15.4, p = 0.026 | b, c | 1, 6 | All-Cause Readmission: F: 11(8.9%); M: 21(15.2%); OR 0.54 (0.25–1.18); Adjusted for women 0.33(0.14–0.79) | Males, All Cause | ||
Omersa (2016) [27] | F: 21711 (59); M: 15113(41) | F: 65–74:19%, 75–84:48%, 85+:33%; M:65–74:36,75–84:48%;85+:16% | c | n.r. | Mortality: 65–74: 0.808 (0.745–0.875) 75–84: 0.848 (0.807–0.891) 85+: 0.840 (0.785–0.898); All Cause Readmission: 65–74:0.872 (0.814–0.934) 75–84:0.869 (0.825–0.915) 85+:0.855 (0.784–0.931) | Males, and lower survival | ||
Robertson (2012) [30] | F:14557 (50); M: 14604 (50) | b,c | n.r. | All-Cause Readmission: 0.93 (0.89–0.96) | Males, All Cause | |||
Sato (2015) [43] | F: 122; M: 476 (79.6) | b,c | 26 | Cardiovascular Readmission: Multivariable male 1.851 HR (1.237–2.771) | Males, Cardiovascular |
Primary Author (year) | Objectives | Setting (geographical location, recruitment period) | Study Design | Study Endpoints |
---|---|---|---|---|
Ahmed (2014) [57] | Examined the impact of gender on a wide variety of major natural history endpoints in a propensity matched population of ambulatory chronic HF patients in which men and women were well balanced on all measured baseline covariates | 302 clinical centers across the United States (186 centers) and Canada (116 centers) between January 1991 and August 1993. | Retrospective observational | Mortality, hospitalizations (all cause, cardiovascular causes and HF) |
Bradford (2016) [32] | To evaluate the diagnosis and timing and to identify patient and clinical characteristics associated with 30 day readmissions among heart failure patients. | Acute care hospitals (San Diego, US, October 2009 to November, 2014) | Retrospective | 30-day Readmissions |
Chang (2014) [48] | To study sex differences in clinical characteristics and outcomes among multi-ethnic Southeast Asian patients with hospitalized heart failure | Hospitals in the Southeast Asian nation of Singapore, January 1, 2008 to December 31, 2009 | Prospective | Length of stay, in hospital mortality and rehospitalisation |
Chun (2012) [35] | Examined a patient cohort discharged after being newly hospitalized for HF and followed them over their lifetime for all cardiac and noncardiac hospitalizations that occurred until death. Examined patterns of hospitalization and recurrent cardiovascular events and the association of sex, presence of HFrEF versus HFpEF, and ischemic versus nonischemic etiology on hospitalizations | Hospitals (Ontario, Canada, April 1999 to March 2001) | Retrospective | Recurrent hospitalizations, cardiovascular events, and survival |
Eastwood (2014) [33] | To identify factors associated with risk of all-cause and HF-specific readmissions within 7 and 30 days of discharge | Acute care hospital in Alberta from April 1, 2002 to March 31, 2012 | Retrospective | 7-and 30-day readmission for all causes, 7-and 30-day readmission for HF |
Gevaert (2014) [47] | To compare the incidence and treatment of atrial fibrillation on admission between men and women admitted with acute heart failure | 2 Belgian hospitals, Nov 2006 to May 2012; Patients included in the prospective BIO-HF registry (evaluates all patients admitted with the New York Heart Association class 3–4) | Prospective design | One-year all-cause mortality or readmission for HF. Secondary endpoints were in-hospital mortality and restoration of sinus rhythm at discharge |
Jenghua (2011) [36] | To determine early readmission rate after discharge among patients with principal diagnosis of CHF and (2) identify predictors of readmission within 30 days after discharge for this group of patients | Tertiary care hospital in a large metropolitan area of Phitsanulok Province, Thailand | Retrospective | Rate of readmission after discharge; predictors of readmission |
Lee (2004) [37] | To evaluate the effect of gender on the risk of all-cause rehospitalization and that specific to heart failure in a diverse contemporary cohort of adults who had been hospitalized with HF | 16 Kaiser Permanente of Northern California facilities (July 1, 1999 to June 302,000) | Retrospective cohort | Any rehospitalisation and readmission due specifically to heart failure |
Mullens (2008) [54] | To investigate whether there is gender-specific differences in clinical presentation, response to intensive medical therapy, and outcomes in patients admitted with advanced decompensated heart failure. | Dedicated heart failure intensive care unit in clinic (USA, 2000 to 2006) | Retrospective | All-cause mortality, all-cause mortality or cardiac transplantation and first readmission for heart failure after discharge |
Nieminen (2008) [53] | To evaluate the gender differences in patients hospitalized for acute heart failure in the EuroHeart Failure Survey II | 133 Hospitals: university hospitals 47, 49% community or district hospitals, 4% private clinics (30 European countries, October 21st 2004 to August 31st 2005) | Prospective | Gender differences in prescription of HF medication; rehospitalizations and one-year mortality |
Ogah (2015) [44] | To evaluate the sex differences in acute heart failure in sub-Saharan Africa | 12 Cardiology units (9 sub-Saharan African countries: Cameroon, Ethiopia, Kenya, Mozambique, Nigeria, Senegal, South Africa, Sudan and Uganda, July 12,007 to June 302,010) | Prospective | Length of hospital stay, mortality rates, and all-cause re-admission |
Opasich (2004) [41] | To identify differences between sexes in the clinical profile, use of resources, management and outcome in a large population of ‘real world’ patients with heart failure | 167 Cardiology (CARD) and 250 internal medicine (MED) departments (Italy, February 14, 2000 to February 25, 2000) | Retrospective | Number of cardiovascular procedures and diagnostic, and pharmacological therapy, in-hospital mortality |
Otero-Ravina (2009) [56] | Characterization of current morbidity and mortality among heart failure in Galicia together with their main determinants | Eight geographical areas of Galicia, year 2006 | Prospective | Survival rates |
Sajeev (2017) [45] | Study the demographical and clinico-pathological characteristics of patients presenting with heart failure and evaluate the 1 year outcomes and to identify risk predictors if any | A tertiary care centre (South India, April 2013–September 2014) | Prospective | Mortality and/or re-hospitalization due to HF |
Schwarz (2003) [55] | To evaluate whether severity of cardiac illness, cognitive functioning, and functional health of older adults with heart failure (HF) and psychosocial factors related to caregiving are predictive of hospital readmissions for those with HF | 2 Community hospitals (Ohio, US) | Prospective | 3-month re-admission |
Sheppard (2005) [34] | To explore gender differences in therapy, resource utilization, and clinical outcomes in patients who had CHF | Quebec hospital summary database linked to provincial physician and drug claims databases, January 1998 and December 2002 | Retrospective | Procedure, medical therapy and re-hospitalizations, emergency room visits |
Tarantini (2002) [51] | Evaluate the clinical characteristics, 1-year prognosis and therapeutic approach of heart failure with a preserved left ventricular systolic function in a large multicenter registry of patients referred to specialized heart failure clinics | 133 Centers of the ANMCO working group on heart failure, March1995 to January 1999 | Prospective | Use of cardiovascular medications, hospitalizations (all-cause for cardiovascular events and for worsening CHF) |
Zsilinskza (2016) [52] | Evaluate sex differences in patients with HFpEF that presented to the ED with acute HF, regarding presentation, treatments, and outcomes. | 83 Hospitals (United States, January 2004 to September 2005) | Retrospective | Emergency department therapies and management, hospital length of stay, in-hospital mortality, post-discharge outcomes |