Short-term adjusted outcomes for heart failure
Short-term adjusted outcomes for heart failure
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DOI：
10.5301/heartint.5000220
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发表时间：
2015-01-01
影响因子：
0.2
通讯作者：
Nante, Nicola
中科院分区：
文献类型：
--
作者：
Messina, Gabriele;Forni, Silvia;Nante, Nicola
目的：心力衰竭（HF）被认为是工业化国家的一个主要问题。短期调整结果是住院期间/之后护理过程质量的指标。我们的目的是评估，主要诊断为HF，住院死亡率和30天再入院的患者使用两种不同的风险调整（RA）tools.Methods和结果：我们使用的数据出院摘要（HD）的回顾性队列的患者（2002-2007年）在托斯卡纳医院，意大利。考虑的结局为30天时的住院死亡率和再入院率。我们比较了所有患者精细诊断相关组（APR-DRG）系统和Elixhauser指数（EI）。进行逻辑回归，并使用C统计量（C）比较模型。检查记录为58.202。粗住院死亡率为9.7%。30天再入院率为5.1%。APR-DRG死亡风险分类（ROD）是院内死亡率的预测因素; APR-DRG严重程度分类与30天再入院无显著相关性（P>0.05）。与预后密切相关的EI合并症是非转移性癌症（OR 2.25，P <0.01）。
Purpose: Heart failure (HF) is recognized as a major problem in industrialized countries. Short-term adjusted outcomes are indicators of quality for care process during/after hospitalization. Our aim is to evaluate, for patients with principal diagnosis of HF, in-hospital mortality and 30-day readmissions for all-causes using two different risk adjustment (RA) tools.Methods and Results: We used data from the hospital discharge abstract (HD) of a retrospective cohort of patients (2002-2007) admitted in Tuscan hospitals, Italy. Considered outcomes were in-hospital mortality and readmission at 30 days. We compared the All-Patients Refined Diagnosis Related Groups (APR-DRG) system and the Elixhauser Index (EI). Logistic regression was performed and models were compared using the C statistic (C). The examined records were 58.202. Crude in-hospital mortality was 9.7%. Thirty-day readmission was 5.1%. The APR-DRG class of risk of death (ROD) was a predictive factor for in-hospital mortality; the APR-DRG class of severity was not significantly associated with 30-day readmissions (P>0.05). EI comorbidities which were more strongly associated with outcomes were nonmetastatic cancer for in-hospital mortality (odds ratio, OR 2.25, P