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, Gregg C. Fonarow

*Corresponding author for this work

Research output: Contribution to journalArticle

43 Scopus citations

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.

Original languageEnglish (US)
Article numbere001134
JournalJournal of the American Heart Association
Volume3
Issue number5
DOIs
StatePublished - 2014

Keywords

  • Health policy and outcome research
  • Heart failure
  • Race/ethnicity
  • Rehospitalization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Vivo, R. P., Krim, S. R., Liang, L., Neely, M., Hernandez, A. F., Eapen, Z. J., Peterson, E. D., Bhatt, D. L., Heidenreich, P. A., Yancy, C. W., & Fonarow, G. C. (2014). Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations. Journal of the American Heart Association, 3(5), [e001134]. https://doi.org/10.1161/JAHA.114.001134