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White Patients Have Higher Mortality Risks from Heart Failure

by U.S. Medicine

May 30, 2017

LOS ANGELES — The proportion of hospitalizations for heart failure with preserved ejection fraction (HFpEF) has increased over the last decade.

A new study published in JACC: Heart Failure examined whether the short- and long-term outcomes differ between racial/ethnic groups. It found that white patients actually fared worse than other racial/ethnic groups.

To do that, a study team led by researchers from the VA Greater Los Angeles Healthcare system linked the Get With The Guidelines-Heart Failure registry to Medicare administrative data from 2006 to 2014 to identify hospitalized patients older than 65 with HFpEF involving left ventricular ejection fraction of 50% or less.  Measured were 30-day and 1-year readmission and mortality rates with sequential adjustments for patient characteristics, hospital characteristics, and social-economic status.

With the final cohort included including 53,065 patients with HFpEF, overall mortality was 5.87% at the 30-day mark and 33.1% at a year. Results indicate that the all-cause 30-day readmission rate was 22.2%, and 67.0% at one year.

After adjusting for patient characteristics, hospital characteristics, and SES, researchers determined that 30-day mortality was lower for black patients with a hazard ratio of 0.84 and Hispanic patients, HR: 0.78, compared with white patients.

The one-year mortality rate, meanwhile, also was lower for black patients, HR: 0.93, and Hispanic patients, HR: 0.83, but it also was lower for Asian patients, HR: 0.76, than white patients.

On the other hand, black patients had a higher risk of readmission at 30 days, HR: 1.09, compared with white patients.

“Black, Hispanic, and Asian patients had a lower mortality risk after a hospitalization for HFpEF compared with white patients; black patients had higher readmission rates,” study authors wrote. “These differences in mortality and readmission risk according to race/ethnicity persisted after adjusting for patient characteristics, SES, and hospital factors.”


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