Risk Factors for In-Hospital Mortality in Heart Failure Patients: Does Rurality, Payer or Admission Source Matter?

Preethy Nayar, Fang Yu, Aastha Chandak, Ge Lin Kan, Brian D Lowes, Bettye A. Apenteng

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)103-108
Number of pages6
JournalJournal of Rural Health
Volume34
Issue number1
DOIs
StatePublished - Dec 1 2018

Fingerprint

Hospital Mortality
Heart Failure
Length of Stay
Comorbidity
Logistic Models
Cost of Illness
Observational Studies
Patient Care
Hospitalization
Retrospective Studies
Regression Analysis
Morbidity
Population

Keywords

  • health services research
  • hospitals
  • medical care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Risk Factors for In-Hospital Mortality in Heart Failure Patients : Does Rurality, Payer or Admission Source Matter? / Nayar, Preethy; Yu, Fang; Chandak, Aastha; Kan, Ge Lin; Lowes, Brian D; Apenteng, Bettye A.

In: Journal of Rural Health, Vol. 34, No. 1, 01.12.2018, p. 103-108.

Research output: Contribution to journalArticle

Nayar, Preethy ; Yu, Fang ; Chandak, Aastha ; Kan, Ge Lin ; Lowes, Brian D ; Apenteng, Bettye A. / Risk Factors for In-Hospital Mortality in Heart Failure Patients : Does Rurality, Payer or Admission Source Matter?. In: Journal of Rural Health. 2018 ; Vol. 34, No. 1. pp. 103-108.
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