Intravenous nesiritide in acute heart failure

The purpose of this study is to evaluate the effect of nesiritide on length of hospital stay, readmission rates, and charges compared with usual care for congestive heart failure (CHF). Using a structured retrospective chart review, we reviewed the records of 127 patients admitted with decompensated CHF, looking at length of stay on initial admission, readmission rates, total hospital days over 3 months, 3-month mortality, pharmacy and hospital charges for the initial admission, and total pharmacy and hospital charges over 3 months. Nesiritide had no effect on initial length of stay, readmission rates, or 3-month mortality. Patients with an ejection fraction >30% who received nesiritide spent more days in the hospital over 3 months than those who received usual care, although there were no differences between the groups in patients with an ejection fraction of < or =30%. Pharmacy and hospital charges for both the initial admission and over 3 months were significantly higher for patients who received nesiritide than for those who received usual care. Patients who received nesiritide incurred significantly higher charges for medical care, but nesiritide did not affect length of stay, readmission rates, or mortality.