Mortality trends for 23,505 Medicare patients hospitalized with heart failure in Northeast Ohio, 1991 to 1997
Mortality trends for 23,505 Medicare patients hospitalized with heart failure in Northeast Ohio, 1991 to 1997
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DOI：
10.1016/s0002-8703(02)94784-8
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发表时间：
2003-08-01
影响因子：
4.8
通讯作者：
Cebul, RD
中科院分区：
文献类型：
--
作者：
Baker, DW;Einstadter, D;Cebul, RD
背景临床试验已经确定了心力衰竭（HF）的主要治疗进展，但HF患者的生存率在一般人群中的改善程度尚不清楚。本研究分析了从1991年至1997年的23,505名医疗保险患者的死亡率趋势，这些患者在俄亥俄州东北部的29家hospital.Methods医院首次因HF入院，我们将克利夫兰健康质量选择（CHQC）计划和医疗保险的数据库连接起来，以确定HF和死亡的首次入院日期。我们使用来自CHQC的图表数据（例如，生命体征、未复苏状态、共病状况和实验室结果）调整了入院时疾病严重程度的变化。结果在基线（1991年），住院、30天和1年的粗死亡率分别为6.4%、8.6%和36.5%。1991年至1997年间，平均住院天数从9.2天急剧下降至6.6天（P
Background Clinical trials have identified major therapeutic advances for heart failure (HF), but the degree to which survival has improved among the general population of patients with HF is not known. This study analyzed mortality trends from 1991 to 1997 for 23,505 Medicare patients hospitalized with a first admission for HF at 29 Northeast Ohio hospitals.Methods We linked databases from the Cleveland Health Quality Choice (CHQC) program and Medicare to allow identification of first admissions,for HF and death, date. We adjusted for changes in admission illness severity using chart data from CHQC (eg, vital signs, do-not-resuscitate status, comorbid conditions, and laboratory results). Logistic regression was used to analyze trends in risk-adjusted mortality.Results At baseline (1991), crude inhospital, 30-day and 1-year mortality rates were 6.4%, 8.6% and 36.5%, respectively. Between 1991 and 1997, mean length of stay declined steeply from 9.2 days to 6.6 days (P