Incidence and risk factors of heart failure in patients with varicose veins of lower extremities: a retrospective nationwide inpatient sample database study

Objective To investigate the incidence and risk factors of (HF)in patients with varicose veins of the lower extremities (VVLEs) using a large-scale national database. Methods We conducted a retrospective analysis using data from the Nationwide Inpatient Sample (NIS) database spanning 2010 to 2019. The study population included individuals diagnosed with VVLEs. Our evaluation covered various parameters, including patient demographics, hospital characteristics, length of stay, total hospitalization charges, in-hospital mortality, comorbidities, and associated clinical complications. Results Analysis of the NIS database identified 120,748 individuals with VVLEs who met the inclusion criteria. HF developed in 16,463 cases within this cohort, resulting in an overall incidence rate of 14.4%. A temporal analysis revealed a substantial increase in HF occurrence throughout the study period, rising from 1.5% in 2010 to 29.8% in 2019. The comparative assessment showed that VVLEs patients with HF experienced more extended hospital stays, incurred higher healthcare costs, were more likely to utilize Medicare, and had higher in-hospital mortality rates than those that did not experience HF ( P  < 0.001). Risk factors for HF included advanced age (≥ 65 years), Black race, comorbidities (n ≥ 1), treatment at a teaching hospital, hospitalization in the South, female sex, private insurance, elective admission, urban hospital setting, chronic pulmonary disease, fluid and electrolyte disorders, obesity, pulmonary circulation disorders, renal failure, valvular disease, weight loss, diabetes with chronic complications, and peptic ulcer disease (excluding bleeding). Moreover, HF was associated with wound infection, blood transfusion, hemorrhage/ seroma/hematoma, deep venous thrombosis, pulmonary embolism, stroke, and cellulitis of the leg. Conclusions Studying the risk factors associated with HF in patients with VVLEs is essential for implementing preventive management strategies and optimizing patient outcomes.