Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure.
Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure.
复制标题
DOI：
10.1016/j.jchf.2018.02.002
复制
发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Spertus JA
中科院分区：
文献类型：
--
作者：
Khariton Y;Nassif ME;Thomas L;Fonarow GC;Mi X;DeVore AD;Duffy C;Sharma PP;Albert NM;Patterson JH;Butler J;Hernandez AF;Williams FB;McCague K;Spertus JA
本研究旨在按性别、人种/种族和社会经济地位（SES）描述心力衰竭和射血分数降低（HFrEF）门诊患者的健康状况。尽管治疗HFrEF患者的主要目标是优化健康状况，但性别、种族/民族和SES是否存在差异尚不清楚。在CHAMP-HF（改变心力衰竭患者的管理）登记研究中，比较了来自140家美国诊所的3，494例患者的性别、种族和SES与健康状况之间的关系，这些关系通过堪萨斯城心肌病患者总体汇总（KCCQ-os）评分（范围0 - 100;评分越高表明健康状况越好）进行测量。SES按家庭总收入分类。分层多元线性回归估计KCCQ-os评分的差异后，调整31例患者的特点和10种药物。总体平均KCCQ-os评分为64.2 ± 24.0，但女性较低（黑人样本的29%;分别为60.3 ± 24.0 vs. 65.9 ± 24.0; p < 0.001）（分别为60.5 ± 25.0 vs. 64.9 ± 23.0; p < 0.001），西班牙裔（分别为59.1 ± 21.0 vs. 64.9 ± 23.0; p < 0.001），以及最低收入人群（<25，000美元;平均值：57.1 vs. 63.1至74.7其他收入类别; p < 0.001）。女性完全调整后的KCCQ-os评分低2.2分（95%置信区间[CI]：−3.8至−0.6; p = 0.007），黑人无差异（p = 0.74），西班牙裔低4.0分（95% CI：-6.6至-1.3; p = 0.003），最贫穷患者最低（比最高收入者低4.7个百分点（95% CI：0.1 - 9.2; p = 0.045;趋势p = 0.003）。在门诊HFrEF患者中，女性、黑人、西班牙裔和贫困患者的健康状况更差，在完全校正分析中，女性、西班牙裔和贫困患者的健康状况仍显着。这表明有机会进一步优化治疗，以减少这些观察到的差异。
This study sought to describe the health status of outpatients with heart failure and reduced ejection fraction (HFrEF) by sex, race/ethnicity, and socioeconomic status (SES). Although a primary goal in treating patients with HFrEF is to optimize health status, whether disparities by sex, race/ethnicity, and SES exist is unknown. In the CHAMP-HF (Change the Management of Patients with Heart Failure) registry, the associations among sex, race, and SES and health status, as measured by the Kansas City Cardiomyopathy Questionnaire-overall summary (KCCQ-os) score (range 0 to 100; higher scores indicate better health status) was compared among 3,494 patients from 140 U.S. clinics. SES was categorized by total household income. Hierarchical multivariate linear regression estimated differences in KCCQ-os score after adjusting for 31 patient characteristics and 10 medications. Overall mean KCCQ-os scores were 64.2 ± 24.0 but lower for women (29% of sample; 60.3 ± 24.0 vs. 65.9 ± 24.0, respectively; p < 0.001), for blacks (60.5 ± 25.0 vs. 64.9 ± 23.0, respectively; p < 0.001), for Hispanics (59.1 ± 21.0 vs. 64.9 ± 23.0, respectively; p < 0.001), and for those with the lowest income (<$25,000; mean: 57.1 vs. 63.1 to 74.7 for other income categories; p < 0.001). Fully adjusted KCCQ-os scores were 2.2 points lower for women (95% confidence interval [CI]: −3.8 to −0.6; p = 0.007), no different for blacks (p = 0.74), 4.0 points lower for Hispanics (95% CI: −6.6 to −1.3; p = 0.003), and lowest in the poorest patients (4.7 points lower than those with the highest income (95% CI: 0.1 to 9.2; p = 0.045; p for trend = 0.003). Among outpatients with HFrEF, women, blacks, Hispanics, and poorer patients had worse health status, which remained significant for women, Hispanics, and poorer patients in fully adjusted analyses. This suggests an opportunity to further optimize treatment to reduce these observed disparities.
登录
查看更多内容
影响因子：
8.1
作者：
Heo S;Moser DK;Lennie TA;Riegel B;Chung ML
通讯作者：
Chung ML
影响因子：
13
作者：
Qian, Feng;Parzynski, Craig S.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.
影响因子：
4.6
作者：
Garin, Olatz;Herdman, Michael;Alonso, Jordi
通讯作者：
Alonso, Jordi
影响因子：
6
作者：
Rector, TS;Anand, IS;Cohn, JN
通讯作者：
Cohn, JN
影响因子：
168.9
作者：
Abraham, William T.;Adamson, Philip B.;Yadav, Jay S.
通讯作者：
Yadav, Jay S.