Background: The effect of left ventricular ejection fraction (LVEF) on short-term clinical outcomes and resource utilization during hospitalization for heart failure has not been evaluated.Methods: In 443 consecutive hospitalizations for heart failure in patients with known LVEF, we compared in-hospital and 30-day mortality, 30-day readmission rates, hospitalization cost, and length of stay between patients with systolic dysfunction (LVEF =< 40%; Group I; n = 286) versus those with diastolic dysfunction (LVEF > 40%; Group II; n = 157).Results: Patients with systolic dysfunction were younger (69 vs 73 years; p = 0.001), less likely to be white (59% vs 73%, p = 0.007), and tended to be male more often (58% vs 49%; p = 0.08) compared to those with diastolic dysfunction. They were less likely to have atrial fibrillation (30% vs 44%; p = 0.002), but equally likely to have hypertension and coronary artery disease. Short-term outcomes and resource utilization, expressed per hospitalization, are shown below:Conclusions: Following hospitalization for heart failure, patients with moderate or severe left ventricular dysfunction have greater resource utilization and readmissions, but similar short-term mortality compared to patients with mild or no systolic dysfunction.