Comorbidity profiles and inpatient outcomes during hospitalization for heart failure: an analysis of the U.S. Nationwide inpatient sample

BMC Cardiovascular Disorders

James O Mudd⁵  Harleah G Buck²  Ruth Masterson Creber¹  Quin E Denfeld⁴  Jill M Gelow⁵  Julie T Bidwell⁴  Christopher V Chien⁵  Christopher S Lee³ 

[1] University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA;The Pennsylvania State University College of Nursing, 201 Health and Human Development East University Park, Philadelphia, PA 16802, USA;Oregon Health & Science University School of Nursing and Knight Cardiovascular Institute, 3455 SW US Veterans Hospital Road, Portland, OR 97239-2941, USA;Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR 97239-2941, USA;Oregon Health & Science University Knight Cardiovascular Institute, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA

关键词: Inpatient;    Outcomes;    Comorbidity;    Heart failure;   

Others  :  848345
DOI  :  10.1186/1471-2261-14-73

 received in 2014-03-25, accepted in 2014-05-30,  发布年份 2014

【 摘 要 】

Background

Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.

Methods

Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (n = 192,327).

Results

Most discharges were characterized by "common" comorbidities. A "lifestyle" profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A "renal" profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A "neurovascular" profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15% longer length of stay (LOS) and 12% greater cost, the renal profile was associated with a 30% higher risk of death, 27% longer LOS and 24% greater cost, and the neurovascular profile was associated with a 45% higher risk of death, 34% longer LOS and 37% greater cost (all p < 0.001).

Conclusions

Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.

【 授权许可】

   
2014 Lee et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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