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Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure.

Publication ,  Journal Article
Dupre, ME; Gu, D; Xu, H; Willis, J; Curtis, LH; Peterson, ED
Published in: J Am Heart Assoc
November 16, 2017

BACKGROUND: Prior studies have documented racial and ethnic disparities in hospitalization among patients with heart failure (HF). However, racial/ethnic differences in trajectories of hospitalization following the diagnosis of HF have not been well characterized. This study examined racial/ethnic differences in individual-level trajectories of hospitalization in older adults with diagnosed HF. METHODS AND RESULTS: Data from a nationally representative prospective cohort of US men and women aged 45 years and older were used to examine the number of hospitalizations reported every 24 months. Participants who were non-Hispanic white, non-Hispanic black, and Hispanic with a reported diagnosis of HF (n=3011) were followed from 1998 to 2014. Results showed a quadratic change in the number of reported hospitalizations following HF diagnosis, with an average of 2.36 (95% confidence interval [CI], 2.19-2.53; P<0.001) hospitalizations within 24 months that decreased by 0.35 (95% CI, -0.45 to -0.25; P<0.001) every 24 months and subsequently increased by 0.03 (95% CI, 0.02-0.05; P<0.001) thereafter. In men, there were no racial/ethnic differences in hospitalizations reported at the time of diagnosis; however, Hispanic men had significant declines in hospitalizations after diagnosis (Hispanic×time=-0.52; 95% CI, -0.99 to -0.05 [P=0.031]) followed by a sizeable increase in hospitalizations at later stages of disease (Hispanic×time2=0.06; 95% CI, 0.00-0.12 [P=0.047]). In women, hospitalizations were consistently high following their diagnosis and black women had significantly more hospitalizations throughout follow-up than white women (black=0.28; 95% CI, 0.00-0.55 [P=0.048]). Racial/ethnic disparities varied by geography and the differences remained significant after adjusting for multiple sociodemographic, psychosocial, behavioral, and physiological factors. CONCLUSIONS: There were significant racial/ethnic differences in trajectories of hospitalization following the diagnosis of HF in US men and women. Racial/ethnic disparities varied by place of residence and the differences persisted after adjustment for multiple risk factors. The findings have important implications that may be crucial to planning the immediate and long-term delivery of care in patients with HF to reduce potentially preventable hospitalizations.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 16, 2017

Volume

6

Issue

11

Location

England

Related Subject Headings

  • United States
  • Sex Factors
  • Risk Factors
  • Racial Groups
  • Prospective Studies
  • Morbidity
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
 

Citation

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Dupre, M. E., Gu, D., Xu, H., Willis, J., Curtis, L. H., & Peterson, E. D. (2017). Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure. J Am Heart Assoc, 6(11). https://doi.org/10.1161/JAHA.117.006290
Dupre, Matthew E., Danan Gu, Hanzhang Xu, Janese Willis, Lesley H. Curtis, and Eric D. Peterson. “Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure.J Am Heart Assoc 6, no. 11 (November 16, 2017). https://doi.org/10.1161/JAHA.117.006290.
Dupre ME, Gu D, Xu H, Willis J, Curtis LH, Peterson ED. Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure. J Am Heart Assoc. 2017 Nov 16;6(11).
Dupre, Matthew E., et al. “Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure.J Am Heart Assoc, vol. 6, no. 11, Nov. 2017. Pubmed, doi:10.1161/JAHA.117.006290.
Dupre ME, Gu D, Xu H, Willis J, Curtis LH, Peterson ED. Racial and Ethnic Differences in Trajectories of Hospitalization in US Men and Women With Heart Failure. J Am Heart Assoc. 2017 Nov 16;6(11).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 16, 2017

Volume

6

Issue

11

Location

England

Related Subject Headings

  • United States
  • Sex Factors
  • Risk Factors
  • Racial Groups
  • Prospective Studies
  • Morbidity
  • Middle Aged
  • Male
  • Humans
  • Hospitalization