Length of stay and readmission in older adults hospitalized for heart failure.
Length of stay and readmission in older adults hospitalized for heart failure.
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DOI：
10.5114/aoms.2019.89702
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Ahmed A
中科院分区：
文献类型：
--
作者：
Arundel C;Lam PH;Faselis C;Sheriff HM;Dooley DJ;Morgan C;Fonarow GC;Aronow WS;Allman RM;Ahmed A
住院时间（LoS）和医院再入院是衡量医疗保健绩效的指标。我们检查了这两个指标在住院失代偿性心力衰竭（HF）的老年患者中的相关性。美国106家医院的4849例心衰住院患者的平均生存时间为5天；其中3777人有5天的LoS。使用LoS 1-5天的倾向评分，我们收集了2723对LoS 1-5天和bb1 - 5天的患者。匹配队列5446例患者在40个基线特征上达到平衡。我们在7045例患者中重复了上述过程，排除了LoS 10天的患者，从而建立了第二个匹配队列，包括2399对LoS 1-5天和6-10天的患者。在匹配的队列中估计与较长LoS相关的结果的风险比（HR）和95%置信区间（CI）。在主要匹配队列（n = 5446）中，5天的LoS与30天的全因再入院风险较高相关（HR = 1.16; 95% CI: 1.04-1.31; p = 0.010），但在更长的随访期间则不然。在8.8年的随访期间，较长的LoS也与较高的死亡风险相关（HR = 1.13; 95% CI: 1.06-1.21; p < 0.001）。LoS与HF再入院无关联。在匹配的敏感性队列（n = 4798）中也观察到类似的关联，该队列排除了10天的LoS患者。在倾向评分匹配的心衰患者平衡队列中，较长的LoS与较差的预后独立相关，当排除10 ~ 10天的LoS时，这种情况仍然存在。
Hospital length of stay (LoS) and hospital readmissions are metrics of healthcare performance. We examined the association between these two metrics in older patients hospitalized with decompensated heart failure (HF). Eight thousand and forty-nine patients hospitalized for HF in 106 U.S. hospitals had a median LoS of 5 days; among them, 3777 had a LoS > 5 days. Using propensity scores for LoS > 5 days, we assembled 2723 pairs of patients with LoS 1–5 vs. > 5 days. The matched cohort of 5446 patients was balanced on 40 baseline characteristics. We repeated the above process in 7045 patients after excluding those with LoS > 10 days, thus assembling a second matched cohort of 2399 pairs of patients with LoS 1–5 vs. 6–10 days. Hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with longer LoS were estimated in matched cohorts. In the primary matched cohort (n = 5446), LoS > 5 days was associated with a higher risk of all-cause readmission at 30 days (HR = 1.16; 95% CI: 1.04–1.31; p = 0.010), but not during longer follow-up. A longer LoS was also associated with a higher risk of mortality during 8.8 years of follow-up (HR = 1.13; 95% CI: 1.06–1.21; p < 0.001). LoS had no association with HF readmission. Similar associations were observed among the matched sensitivity cohort (n = 4798) that excluded patients with LoS > 10 days. In propensity score-matched balanced cohorts of patients with HF, a longer LoS was independently associated with poor outcomes, which persisted when LoS > 10 days were excluded.
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影响因子：
37.8
作者：
Chee, Tingyin T.;Ryan, Andrew M.;Borden, William B.
通讯作者：
Borden, William B.
DOI：
10.5114/amsad.2016.63002
发表时间：
2016
期刊：
Archives of medical sciences. Atherosclerotic diseases
影响因子：
--
作者：
Aronow WS
通讯作者：
Aronow WS
DOI：
10.5114/aoms.2016.59927
发表时间：
2016-06-01
期刊：
Archives of medical science : AMS
影响因子：
--
作者：
Pierre-Louis B;Rodriques S;Gorospe V;Guddati AK;Aronow WS;Ahn C;Wright M
通讯作者：
Wright M
影响因子：
5.9
作者：
Ahmed, Ali;Fonarow, Gregg C.;Zhang, Yan;Sanders, Paul W.;Allman, Richard M.;Arnett, Donna K.;Feller, Margaret A.;Love, Thomas E.;Aban, Inmaculada B.;Levesque, Raynald;Ekundayo, O. James;Dell'Italia, Louis J.;Bakris, George L.;Rich, Michael W.
通讯作者：
Rich, Michael W.
影响因子：
5.9
作者：
Ahmed, Ali;Bourge, Robert C.;Allman, Richard M.
通讯作者：
Allman, Richard M.