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Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure.

Publication ,  Journal Article
Thomas, KL; Hernandez, AF; Dai, D; Heidenreich, P; Fonarow, GC; Peterson, ED; Yancy, CW
Published in: Am Heart J
April 2011

BACKGROUND: Black and Hispanic populations are at increased risk for developing heart failure (HF) at a younger age and experience differential morbidity and possibly differential mortality compared with whites. Yet, there have been insufficient data characterizing the clinical presentation, quality of care, and outcomes of patients hospitalized with HF as a function of race/ethnicity. METHODS: We analyzed 78,801 patients from 257 hospitals voluntarily participating in the American Heart Association's Get With The Guidelines-HF Program from January 2005 thru December 2008. There were 56,266 (71.4%) white, 17,775 (22.6%) black, and 4,760 (6.0%) Hispanic patients. In patients hospitalized with HF, we sought to assess clinical characteristics, adherence to core and other guideline-based HF care measures, and in-hospital mortality as a function of race and ethnicity. RESULTS: Relative to white patients, Hispanic and black patients were significantly younger (median age 78.0, 63.0, 64.0 years, respectively), had lower left ventricular ejection fractions, and had more diabetes mellitus and hypertension. With few exceptions, the provision of guideline-based care was comparable for black, Hispanic, and white patients. Black and Hispanic patients had lower in-hospital mortality than white patients: black/white odds ratio 0.69, 95% CI 0.62-0.78, P < .001 and Hispanic/white odds ratio 0.81, 95% CI 0.67-0.98, P = .03. CONCLUSIONS: Hispanic and black patients hospitalized with HF have more cardiovascular risk factors than white patients; however; they have similar or better in-hospital mortality rates. Within the context of a national HF quality improvement program, HF care was equitable and improved in all racial/ethnic groups over time.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2011

Volume

161

Issue

4

Start / End Page

746 / 754

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Quality of Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospital Mortality
  • Hispanic or Latino
  • Heart Failure
 

Citation

APA
Chicago
ICMJE
MLA
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Thomas, K. L., Hernandez, A. F., Dai, D., Heidenreich, P., Fonarow, G. C., Peterson, E. D., & Yancy, C. W. (2011). Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure. Am Heart J, 161(4), 746–754. https://doi.org/10.1016/j.ahj.2011.01.012
Thomas, Kevin L., Adrian F. Hernandez, David Dai, Paul Heidenreich, Gregg C. Fonarow, Eric D. Peterson, and Clyde W. Yancy. “Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure.Am Heart J 161, no. 4 (April 2011): 746–54. https://doi.org/10.1016/j.ahj.2011.01.012.
Thomas KL, Hernandez AF, Dai D, Heidenreich P, Fonarow GC, Peterson ED, et al. Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure. Am Heart J. 2011 Apr;161(4):746–54.
Thomas, Kevin L., et al. “Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure.Am Heart J, vol. 161, no. 4, Apr. 2011, pp. 746–54. Pubmed, doi:10.1016/j.ahj.2011.01.012.
Thomas KL, Hernandez AF, Dai D, Heidenreich P, Fonarow GC, Peterson ED, Yancy CW. Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure. Am Heart J. 2011 Apr;161(4):746–754.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

April 2011

Volume

161

Issue

4

Start / End Page

746 / 754

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Quality of Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospital Mortality
  • Hispanic or Latino
  • Heart Failure