The Association Between Chronic Heart Failure and Metabolic Syndrome Increases Cost of Hospitalization

Background/Objectives. The study aims to observe and compare the real-world total costs of hospitalization in patients with chronic heart failure (CHF) and metabolic syndrome (MetS) from an upper-middle-income European country. Methods. Data were electronically retrieved from three different internal medicine departments of university hospitals in Bucharest, Romania, including all admissions from December 2023 to June 2024. Collected data included demographics, cost of hospitalization (€), and discharge diagnoses (ICD10 codes, used to calculate the Charleston comorbidity index - CCI and to define a MetS surrogate definition). Results. Database query retrieved 4732 hospitalizations (median duration of 4 days; median cost of 1002€) of unique patients (53.9% women, average age of 68.7 years), of whom 48.0% had CHF and 11.0% classified as MetS. Compared to men, women were significantly older, with significantly higher prevalence of CHF, but similar median hospitalization duration and costs. Compared to patients without CHF or MetS, those with CHF or MetS were significantly older, with more comorbidities (CCI) and with higher median hospitalization duration, total cost and cost/day of hospitalization. The total cost of hospitalization increases steadily from a minimum in patients without CHF or Met to a maximum in patients with both conditions. Conclusions. CHF is highly prevalent among patients admitted to internal medicine wards and it is more prevalent among hospitalized women, without significant hospitalization cost differences compared to men. CHF and MetS incrementally increased the total costs of hospitalization in a DRG-based reimbursement systems.