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Quality of care and outcomes in women hospitalized for heart failure.

Publication ,  Journal Article
Klein, L; Grau-Sepulveda, MV; Bonow, RO; Hernandez, AF; Williams, MV; Bhatt, DL; Fonarow, GC
Published in: Circ Heart Fail
September 2011

BACKGROUND: Although women account for a significant proportion of heart failure (HF) hospitalizations, data on the quality of care and in-hospital outcomes in women are limited. METHODS AND RESULTS: We examined The Joint Commission performance measures, other quality metrics, length of stay, and in-hospital mortality in women using 99 841 HF admissions (January 2005 to June 2009) at 248 hospitals participating in the American Heart Association Get With The Guidelines-Heart Failure registry. Women accounted for 50% of the HF admissions and were older (mean age, 74±14 versus 69±14 years), more likely to have hypertension (77% versus 72%), and less likely to have coronary disease (44% versus 53%) or renal insufficiency (18% versus 23%) than men (all P<0.001). The presenting symptoms were similar to men, but women had higher admission systolic blood pressure (mean, 144±31 versus 137±30 mm Hg; P<0.001) and ejection fraction (mean, 0.44±0.17% versus 0.34±0.16%; P<0.001). After adjustment for baseline differences, eligible women were less likely than men to have measurement of left ventricular function (adjusted odds ratio [OR], 0.81; 95% CI, 0.76 to 0.86) and to receive anticoagulation for atrial fibrillation (adjusted OR, 0.91; 95% CI, 0.86 to 0.96) or implantable cardioverter-defibrillators (adjusted OR, 0.70; 95% CI, 0.65 to 0.75) but were as likely to receive discharge instructions, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and smoking cessation counseling at discharge. Although the median length of stay was 4 days, women were more likely than men to be hospitalized >4 days (adjusted OR, 1.13; 95% CI, 1.10 to 1.16) and >7 days (adjusted OR, 1.07; 95% CI, 1.04 to 1.11). Women had comparable in-hospital mortality to men (adjusted OR, 1.05; 95% CI, 0.96 to 1.14). CONCLUSIONS: Compared to men, women hospitalized for HF differ in many clinical characteristics and length of stay but have similar clinical presentations, receive similar quality of care for most but not all measures, and experience similar in-hospital mortality.

Duke Scholars

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

September 2011

Volume

4

Issue

5

Start / End Page

589 / 598

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Quality of Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Inpatients
  • Humans
  • Hospital Mortality
 

Citation

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Klein, L., Grau-Sepulveda, M. V., Bonow, R. O., Hernandez, A. F., Williams, M. V., Bhatt, D. L., & Fonarow, G. C. (2011). Quality of care and outcomes in women hospitalized for heart failure. Circ Heart Fail, 4(5), 589–598. https://doi.org/10.1161/CIRCHEARTFAILURE.110.960484
Klein, Liviu, Maria V. Grau-Sepulveda, Robert O. Bonow, Adrian F. Hernandez, Mark V. Williams, Deepak L. Bhatt, and Gregg C. Fonarow. “Quality of care and outcomes in women hospitalized for heart failure.Circ Heart Fail 4, no. 5 (September 2011): 589–98. https://doi.org/10.1161/CIRCHEARTFAILURE.110.960484.
Klein L, Grau-Sepulveda MV, Bonow RO, Hernandez AF, Williams MV, Bhatt DL, et al. Quality of care and outcomes in women hospitalized for heart failure. Circ Heart Fail. 2011 Sep;4(5):589–98.
Klein, Liviu, et al. “Quality of care and outcomes in women hospitalized for heart failure.Circ Heart Fail, vol. 4, no. 5, Sept. 2011, pp. 589–98. Pubmed, doi:10.1161/CIRCHEARTFAILURE.110.960484.
Klein L, Grau-Sepulveda MV, Bonow RO, Hernandez AF, Williams MV, Bhatt DL, Fonarow GC. Quality of care and outcomes in women hospitalized for heart failure. Circ Heart Fail. 2011 Sep;4(5):589–598.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

September 2011

Volume

4

Issue

5

Start / End Page

589 / 598

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Quality of Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Inpatients
  • Humans
  • Hospital Mortality