-
Comparative Study
Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations.
- Rey P Vivo, Selim R Krim, Li Liang, Megan Neely, Adrian F Hernandez, Zubin J Eapen, Eric D Peterson, Deepak L Bhatt, Paul A Heidenreich, Clyde W Yancy, and Gregg C Fonarow.
- Ronald Reagan-UCLA Medical Center, Los Angeles, CA (R.P.V., G.C.F.).
- J Am Heart Assoc. 2014 Oct 1; 3 (5): e001134.
BackgroundThe 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 ResultsUsing 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.ConclusionsAmong 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.© 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
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