A Comparison of Clinical Characteristics, Outcomes, and Predictors of Adverse Outcomes in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction: A Retrospective Study.

内容摘要

Background and objective Heart failure (HF) is a leading cause of morbidity and mortality worldwide and is broadly classified into heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), which differ in pathophysiology, clinical profile, and outcomes. This study aimed to compare the demographic characteristics, clinical profile, comorbidity burden, and short-term clinical outcomes, including in-hospital mortality, length of hospital stay, and 30-day readmission, between patients with HFpEF&#xa0;and HFrEF, and to identify independent predictors of adverse clinical outcomes. Methodology This retrospective comparative observational study was conducted at Shalamar Hospital, Lahore, Pakistan, from March 2023 to March 2026. A total of 305 patients with confirmed heart failure were included using non-probability consecutive sampling. Patients were categorized into HFrEF (left ventricular ejection fraction (LVEF) < 40%) and HFpEF (LVEF &#x2265; 50%) groups. Data were extracted from medical records using a structured proforma. Results Of 305 patients, 182 (59.7%) had HFrEF and 123 (40.3%) had HFpEF. Patients with HFpEF were significantly older and had a higher prevalence of hypertension, diabetes mellitus, and obesity (p < 0.05). HFrEF patients more commonly had ischemic heart disease and presented with more advanced symptoms (p < 0.05). In-hospital mortality was higher in HFrEF compared to HFpEF (26, 14.3% vs. 10, 8.1%), although the difference was not statistically significant (p = 0.089). HFrEF was associated with longer hospital stay (7.6 &#xb1; 3.2 vs. 5.9 &#xb1; 2.7 days, p = 0.001) and higher 30-day readmission rates (50, 27.5%&#xa0;vs. 23, 18.7%, p = 0.045). Conclusions HFrEF is associated with worse short-term clinical outcomes, including prolonged hospitalization and higher readmission rates, whereas HFpEF is associated with a greater burden of comorbid conditions.