Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations.

Abstract

BACKGROUND: The degree to which outcomes following hospitalization for acute heart failure (HF) vary by racial and ethnic groups is poorly characterized. We sought to compare 30-day and 1-year rehospitalization and mortality rates for HF among 4 race/ethnic groups. METHODS AND RESULTS: Using the Get With The Guidelines-HF registry linked with Medicare data, we compared 30-day and 1-year outcomes between racial/ethnic groups by using a multivariable Cox proportional hazards model adjusting for clinical, hospital, and socioeconomic status characteristics. We analyzed 47 149 Medicare patients aged ≥65 years who had been discharged for HF between 2005 and 2011: there were 39 213 whites (83.2%), 4946 blacks (10.5%), 2347 Hispanics (5.0%), and 643 Asians/Pacific Islanders (1.4%). Relative to whites, blacks and Hispanics had higher 30-day and 1-year unadjusted readmission rates but lower 30-day and 1-year mortality; Asians had similar 30-day readmission rates but lower 1-year mortality. After risk adjustment, blacks had higher 30-day and 1-year CV readmission than whites but modestly lower short- and long-term mortality; Hispanics had higher 30-day and 1-year readmission rates and similar 1-year mortality than whites, while Asians had similar outcomes. When socioeconomic status data were added to the model, the majority of associations persisted, but the difference in 30-day and 1-year readmission rates between white and Hispanic patients became nonsignificant. CONCLUSIONS: Among Medicare patients hospitalized with HF, short- and long-term readmission rates and mortality differed among the 4 major racial/ethnic populations and persisted even after controlling for clinical, hospital, and socioeconomic status variables.

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Citation

Published Version (Please cite this version)

10.1161/JAHA.114.001134

Publication Info

Vivo, Rey P, Selim R Krim, Li Liang, Megan Neely, Adrian F Hernandez, Zubin J Eapen, Eric D Peterson, Deepak L Bhatt, et al. (2014). Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations. J Am Heart Assoc, 3(5). p. e001134. 10.1161/JAHA.114.001134 Retrieved from https://hdl.handle.net/10161/15009.

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Scholars@Duke

Neely

Megan Lee Neely

Assistant Professor of Biostatistics & Bioinformatics

Statistical Genetics; Variable Selection (esp. penalized likelihood methods); Individualized Medicine; Biomarkers; Applications in Clinical Research; Statistical Education

Hernandez

Adrian Felipe Hernandez

Duke Health Cardiology Professor
Eapen

Zubin John Eapen

Adjunct Associate Professor in the Department of Medicine

As director of the Duke Heart Failure Same-Day Access Clinic, I am dedicated to improving outcomes for patients with heart failure. This clinic allows patients to see a health care provider quickly, and receive treatments for relief of symptoms. I strive to help patients with heart failure avoid the emergency department and hospital when possible, and live better at home.

As director of education IT innovations in the Department of Medicine, I lead efforts in continuing medical education.


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