Paula Martínez Santos1, Ramón Bover Freire2, Alberto Esteban Fernández2, José Luis Bernal Sobrino3, Cristina Fernández Pérez4, Francisco Javier Elola Somoza5, Carlos Macaya Miguel2, Isidre Vilacosta2. 1. Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: paulams1@hotmail.com. 2. Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. 3. Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain. 4. Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Departamento de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain. 5. Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Heart failure (HF) is a major health care problem in Spain. Epidemiological data from hospitalized patients are scarce and the association between hospital characteristics and patient outcomes is largely unknown. The aim of this study was to identify the factors associated with in-hospital mortality and readmissions and to analyze the relationship between hospital characteristics and outcomes. METHODS: A retrospective analysis of discharges with HF as the principal diagnosis at hospitals of the Spanish National Health System in 2012 was performed using the Minimum Basic Data Set. We calculated risk-standardized mortality rates (RSMR) at the index episode and risk-standardized cardiac diseases readmissions rates (RSRR) and in-hospital mortality at 30 days and 1 year after discharge by using a multivariate mixed model. RESULTS: We included 77 652 HF patients. Mean age was 79.2±9.9 years and 55.3% were women. In-hospital mortality during the index episode was 9.2%, rising to 14.5% throughout the year of follow-up. The 1-year cardiovascular readmissions rate was 32.6%. RSMR were lower among patients discharged from high-volume hospitals (> 340 HF discharges) (in-hospital RSMR, 10.3±5.6%; 8.6±2.2%); P <.001). High-volume hospitals had higher 1-year RSRR (32.3±3.7%; 33.7±4.5%; P=.006). The availability of a cardiology department at the hospital was associated with better outcomes (in-hospital RSMR, 9.9±3.8%; 9.2±2.4%; P <.001). CONCLUSIONS: High-volume hospitals and the availability of a cardiology department were associated with lower in-hospital mortality.
INTRODUCTION AND OBJECTIVES:Heart failure (HF) is a major health care problem in Spain. Epidemiological data from hospitalized patients are scarce and the association between hospital characteristics and patient outcomes is largely unknown. The aim of this study was to identify the factors associated with in-hospital mortality and readmissions and to analyze the relationship between hospital characteristics and outcomes. METHODS: A retrospective analysis of discharges with HF as the principal diagnosis at hospitals of the Spanish National Health System in 2012 was performed using the Minimum Basic Data Set. We calculated risk-standardized mortality rates (RSMR) at the index episode and risk-standardized cardiac diseases readmissions rates (RSRR) and in-hospital mortality at 30 days and 1 year after discharge by using a multivariate mixed model. RESULTS: We included 77 652 HF patients. Mean age was 79.2±9.9 years and 55.3% were women. In-hospital mortality during the index episode was 9.2%, rising to 14.5% throughout the year of follow-up. The 1-year cardiovascular readmissions rate was 32.6%. RSMR were lower among patients discharged from high-volume hospitals (> 340 HF discharges) (in-hospital RSMR, 10.3±5.6%; 8.6±2.2%); P <.001). High-volume hospitals had higher 1-year RSRR (32.3±3.7%; 33.7±4.5%; P=.006). The availability of a cardiology department at the hospital was associated with better outcomes (in-hospital RSMR, 9.9±3.8%; 9.2±2.4%; P <.001). CONCLUSIONS: High-volume hospitals and the availability of a cardiology department were associated with lower in-hospital mortality.
Authors: Rosa Antonio-Oriola; Ercole Vellone; Angela Durante; Maddalena De Maria; Marco Di Nitto; Vicente Gea-Caballero; Iván Santolalla-Arnedo; Michał Czapla; José Vicente Benavent-Cervera; Juan Luis Sánchez-González; Raúl Juárez-Vela Journal: J Pers Med Date: 2022-04-12
Authors: Radosław Sierpiński; Justyna M Sokolska; Tomasz Suchocki; Beata Koń; Filip Urbański; Marcin Kruk; Mateusz Sokolski; Piotr Ponikowski; Ewa A Jankowska Journal: ESC Heart Fail Date: 2020-10-22