Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?
Purpose Considering the high prevalence of heart failure and the economic burden of the disease, factors that influence in‐hospital mortality are of importance in improving outcomes of care for this patient population. The purpose of this study was to examine the determinants of in‐hospital mortalit...
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| Veröffentlicht in: | The Journal of rural health 2018-12, Vol.34 (1), p.103-108 |
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| container_title | The Journal of rural health |
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| creator | Nayar, Preethy Yu, Fang Chandak, Aastha Kan, Ge Lin Lowes, Brian Apenteng, Bettye A. |
| description | Purpose
Considering the high prevalence of heart failure and the economic burden of the disease, factors that influence in‐hospital mortality are of importance in improving outcomes of care for this patient population. The purpose of this study was to examine the determinants of in‐hospital mortality for adult heart failure patients.
Methods
The study design is a retrospective observational study design using the 2010 Nebraska Hospital Discharge data set including 4,319 hospitalizations for 3,521 heart failure patients admitted to 79 hospitals in Nebraska. Hierarchical logistic regression models including patient‐ and hospital‐specific random intercepts were analyzed. Covariates included in the analysis were patient age in years, gender, comorbidity status, length of stay, primary payer, type and source of admission, transfers, and rurality of county of residence.
Results
Overall, 3.5% of heart failure patients died during their hospital stay. In logistic regression analysis that adjusted for age, sex, and comorbidities, the odds of dying in hospital for heart failure patients increased with age (OR = 1.03, 95% CI: 1.01‐1.04), co‐morbidity (OR = 1.15; 95% CI: 1.05‐1.25) and length of stay (OR = 1.03, 95% CI: 1.01‐1.05). The patient's gender, payer source, rurality of county of residence, source, and type of admission were not risk factors for in‐hospital death.
Conclusion
Increasing age, comorbidity and length of stay were risk factors for in‐hospital death for heart failure. An understanding of the risk factors for in‐hospital death is critical to improving outcomes of care for heart failure patients. |
| doi_str_mv | 10.1111/jrh.12186 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826699150</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826699150</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-d1d9cc5d4f2cd59022fbd8d0a0cfbdb48c9eef17ca559e7c75064f24f9b5b74c3</originalsourceid><addsrcrecordid>eNp1kctq3DAUhkVoSSaXRV-gCLpJoE50sSyrmxJy6aQkJExS6E7I8jHV1GNNJJkwuzxCn7FPUjWTdhGINkdwPj5-zo_QO0oOaX5H8_DjkDJaVxtoQmVZF4RX9A2akFqRQlbi-xbajnFOCFM1LzfRFpNMcsnFBKWZiz_xubHJh4g7H_DF8Pvx19THpUumx1c-5OHSCrsBT8GElGHXjwHwjUkOhhQ_4VMPEc_G8AR-zIsVBJxVx-3Cxej8gG_9GCzgK5MShM-76G1n-gh7z3MHfTs_uzuZFpfXXy5Oji8LywWvipa2ylrRlh2zrVCEsa5p65YYYvOnKWurADoqrRFCgbRSkCqzZaca0cjS8h20v_Yug78fISad81joezOAH6OmNasqpaggGf3wAp3nyENOp2k-WsW5YipTB2vKBh9jgE4vg1uYsNKU6L9V6FyFfqois--fjWOzgPY_-e_2GThaAw-uh9XrJv11Nl0r_wBv6ZR6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1983633929</pqid></control><display><type>article</type><title>Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?</title><source>Wiley Online Library Journals Frontfile Complete</source><source>PAIS Index</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Nayar, Preethy ; Yu, Fang ; Chandak, Aastha ; Kan, Ge Lin ; Lowes, Brian ; Apenteng, Bettye A.</creator><creatorcontrib>Nayar, Preethy ; Yu, Fang ; Chandak, Aastha ; Kan, Ge Lin ; Lowes, Brian ; Apenteng, Bettye A.</creatorcontrib><description>Purpose
Considering the high prevalence of heart failure and the economic burden of the disease, factors that influence in‐hospital mortality are of importance in improving outcomes of care for this patient population. The purpose of this study was to examine the determinants of in‐hospital mortality for adult heart failure patients.
Methods
The study design is a retrospective observational study design using the 2010 Nebraska Hospital Discharge data set including 4,319 hospitalizations for 3,521 heart failure patients admitted to 79 hospitals in Nebraska. Hierarchical logistic regression models including patient‐ and hospital‐specific random intercepts were analyzed. Covariates included in the analysis were patient age in years, gender, comorbidity status, length of stay, primary payer, type and source of admission, transfers, and rurality of county of residence.
Results
Overall, 3.5% of heart failure patients died during their hospital stay. In logistic regression analysis that adjusted for age, sex, and comorbidities, the odds of dying in hospital for heart failure patients increased with age (OR = 1.03, 95% CI: 1.01‐1.04), co‐morbidity (OR = 1.15; 95% CI: 1.05‐1.25) and length of stay (OR = 1.03, 95% CI: 1.01‐1.05). The patient's gender, payer source, rurality of county of residence, source, and type of admission were not risk factors for in‐hospital death.
Conclusion
Increasing age, comorbidity and length of stay were risk factors for in‐hospital death for heart failure. An understanding of the risk factors for in‐hospital death is critical to improving outcomes of care for heart failure patients.</description><identifier>ISSN: 0890-765X</identifier><identifier>EISSN: 1748-0361</identifier><identifier>DOI: 10.1111/jrh.12186</identifier><identifier>PMID: 27273735</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Age ; Beta blockers ; Comorbidity ; Death ; Death & dying ; Gender ; health services research ; Heart diseases ; Heart failure ; Hospitalization ; Hospitals ; Length of stay ; medical care ; Morbidity ; Mortality ; Patients ; Regression analysis ; Regression models ; Residence ; Risk analysis ; Risk factors ; Rural areas ; Rurality</subject><ispartof>The Journal of rural health, 2018-12, Vol.34 (1), p.103-108</ispartof><rights>2016 National Rural Health Association</rights><rights>2016 National Rural Health Association.</rights><rights>2018 National Rural Health Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-d1d9cc5d4f2cd59022fbd8d0a0cfbdb48c9eef17ca559e7c75064f24f9b5b74c3</citedby><cites>FETCH-LOGICAL-c3536-d1d9cc5d4f2cd59022fbd8d0a0cfbdb48c9eef17ca559e7c75064f24f9b5b74c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjrh.12186$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjrh.12186$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27847,27905,27906,30980,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27273735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nayar, Preethy</creatorcontrib><creatorcontrib>Yu, Fang</creatorcontrib><creatorcontrib>Chandak, Aastha</creatorcontrib><creatorcontrib>Kan, Ge Lin</creatorcontrib><creatorcontrib>Lowes, Brian</creatorcontrib><creatorcontrib>Apenteng, Bettye A.</creatorcontrib><title>Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?</title><title>The Journal of rural health</title><addtitle>J Rural Health</addtitle><description>Purpose
Considering the high prevalence of heart failure and the economic burden of the disease, factors that influence in‐hospital mortality are of importance in improving outcomes of care for this patient population. The purpose of this study was to examine the determinants of in‐hospital mortality for adult heart failure patients.
Methods
The study design is a retrospective observational study design using the 2010 Nebraska Hospital Discharge data set including 4,319 hospitalizations for 3,521 heart failure patients admitted to 79 hospitals in Nebraska. Hierarchical logistic regression models including patient‐ and hospital‐specific random intercepts were analyzed. Covariates included in the analysis were patient age in years, gender, comorbidity status, length of stay, primary payer, type and source of admission, transfers, and rurality of county of residence.
Results
Overall, 3.5% of heart failure patients died during their hospital stay. In logistic regression analysis that adjusted for age, sex, and comorbidities, the odds of dying in hospital for heart failure patients increased with age (OR = 1.03, 95% CI: 1.01‐1.04), co‐morbidity (OR = 1.15; 95% CI: 1.05‐1.25) and length of stay (OR = 1.03, 95% CI: 1.01‐1.05). The patient's gender, payer source, rurality of county of residence, source, and type of admission were not risk factors for in‐hospital death.
Conclusion
Increasing age, comorbidity and length of stay were risk factors for in‐hospital death for heart failure. An understanding of the risk factors for in‐hospital death is critical to improving outcomes of care for heart failure patients.</description><subject>Age</subject><subject>Beta blockers</subject><subject>Comorbidity</subject><subject>Death</subject><subject>Death & dying</subject><subject>Gender</subject><subject>health services research</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Length of stay</subject><subject>medical care</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Residence</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Rural areas</subject><subject>Rurality</subject><issn>0890-765X</issn><issn>1748-0361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNp1kctq3DAUhkVoSSaXRV-gCLpJoE50sSyrmxJy6aQkJExS6E7I8jHV1GNNJJkwuzxCn7FPUjWTdhGINkdwPj5-zo_QO0oOaX5H8_DjkDJaVxtoQmVZF4RX9A2akFqRQlbi-xbajnFOCFM1LzfRFpNMcsnFBKWZiz_xubHJh4g7H_DF8Pvx19THpUumx1c-5OHSCrsBT8GElGHXjwHwjUkOhhQ_4VMPEc_G8AR-zIsVBJxVx-3Cxej8gG_9GCzgK5MShM-76G1n-gh7z3MHfTs_uzuZFpfXXy5Oji8LywWvipa2ylrRlh2zrVCEsa5p65YYYvOnKWurADoqrRFCgbRSkCqzZaca0cjS8h20v_Yug78fISad81joezOAH6OmNasqpaggGf3wAp3nyENOp2k-WsW5YipTB2vKBh9jgE4vg1uYsNKU6L9V6FyFfqois--fjWOzgPY_-e_2GThaAw-uh9XrJv11Nl0r_wBv6ZR6</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Nayar, Preethy</creator><creator>Yu, Fang</creator><creator>Chandak, Aastha</creator><creator>Kan, Ge Lin</creator><creator>Lowes, Brian</creator><creator>Apenteng, Bettye A.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20181201</creationdate><title>Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?</title><author>Nayar, Preethy ; Yu, Fang ; Chandak, Aastha ; Kan, Ge Lin ; Lowes, Brian ; Apenteng, Bettye A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-d1d9cc5d4f2cd59022fbd8d0a0cfbdb48c9eef17ca559e7c75064f24f9b5b74c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Beta blockers</topic><topic>Comorbidity</topic><topic>Death</topic><topic>Death & dying</topic><topic>Gender</topic><topic>health services research</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Length of stay</topic><topic>medical care</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Residence</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Rural areas</topic><topic>Rurality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nayar, Preethy</creatorcontrib><creatorcontrib>Yu, Fang</creatorcontrib><creatorcontrib>Chandak, Aastha</creatorcontrib><creatorcontrib>Kan, Ge Lin</creatorcontrib><creatorcontrib>Lowes, Brian</creatorcontrib><creatorcontrib>Apenteng, Bettye A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of rural health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nayar, Preethy</au><au>Yu, Fang</au><au>Chandak, Aastha</au><au>Kan, Ge Lin</au><au>Lowes, Brian</au><au>Apenteng, Bettye A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?</atitle><jtitle>The Journal of rural health</jtitle><addtitle>J Rural Health</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>34</volume><issue>1</issue><spage>103</spage><epage>108</epage><pages>103-108</pages><issn>0890-765X</issn><eissn>1748-0361</eissn><abstract>Purpose
Considering the high prevalence of heart failure and the economic burden of the disease, factors that influence in‐hospital mortality are of importance in improving outcomes of care for this patient population. The purpose of this study was to examine the determinants of in‐hospital mortality for adult heart failure patients.
Methods
The study design is a retrospective observational study design using the 2010 Nebraska Hospital Discharge data set including 4,319 hospitalizations for 3,521 heart failure patients admitted to 79 hospitals in Nebraska. Hierarchical logistic regression models including patient‐ and hospital‐specific random intercepts were analyzed. Covariates included in the analysis were patient age in years, gender, comorbidity status, length of stay, primary payer, type and source of admission, transfers, and rurality of county of residence.
Results
Overall, 3.5% of heart failure patients died during their hospital stay. In logistic regression analysis that adjusted for age, sex, and comorbidities, the odds of dying in hospital for heart failure patients increased with age (OR = 1.03, 95% CI: 1.01‐1.04), co‐morbidity (OR = 1.15; 95% CI: 1.05‐1.25) and length of stay (OR = 1.03, 95% CI: 1.01‐1.05). The patient's gender, payer source, rurality of county of residence, source, and type of admission were not risk factors for in‐hospital death.
Conclusion
Increasing age, comorbidity and length of stay were risk factors for in‐hospital death for heart failure. An understanding of the risk factors for in‐hospital death is critical to improving outcomes of care for heart failure patients.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27273735</pmid><doi>10.1111/jrh.12186</doi><tpages>6</tpages></addata></record> |
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| ispartof | The Journal of rural health, 2018-12, Vol.34 (1), p.103-108 |
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| source | Wiley Online Library Journals Frontfile Complete; PAIS Index; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Age Beta blockers Comorbidity Death Death & dying Gender health services research Heart diseases Heart failure Hospitalization Hospitals Length of stay medical care Morbidity Mortality Patients Regression analysis Regression models Residence Risk analysis Risk factors Rural areas Rurality |
| title | Risk Factors for In‐Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter? |
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