Comorbidity profiles and inpatient outcomes during hospitalization for heart failure

An analysis of the U.S. Nationwide inpatient sample

Christopher Lee, Christopher Chien, Julie T. Bidwell, Jill Gelow, Quin Denfeld, Ruth M. Creber, Harleah G. Buck, James Mudd

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.Methods: Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (n = 192,327).Results: Most discharges were characterized by "common" comorbidities. A "lifestyle" profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A "renal" profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A "neurovascular" profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15% longer length of stay (LOS) and 12% greater cost, the renal profile was associated with a 30% higher risk of death, 27% longer LOS and 24% greater cost, and the neurovascular profile was associated with a 45% higher risk of death, 34% longer LOS and 37% greater cost (all p <0.001).Conclusions: Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.

Original languageEnglish (US)
Article number73
JournalBMC Cardiovascular Disorders
Volume14
DOIs
StatePublished - Jun 5 2014

Fingerprint

Comorbidity
Inpatients
Hospitalization
Heart Failure
Length of Stay
Costs and Cost Analysis
Kidney
Life Style
Cerebrovascular Disorders
Peripheral Vascular Diseases
Treatment Failure
Pulmonary Hypertension
Paralysis
Electrolytes
Obesity
Myocardial Infarction

Keywords

  • Comorbidity
  • Heart failure
  • Inpatient
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Comorbidity profiles and inpatient outcomes during hospitalization for heart failure : An analysis of the U.S. Nationwide inpatient sample. / Lee, Christopher; Chien, Christopher; Bidwell, Julie T.; Gelow, Jill; Denfeld, Quin; Creber, Ruth M.; Buck, Harleah G.; Mudd, James.

In: BMC Cardiovascular Disorders, Vol. 14, 73, 05.06.2014.

Research output: Contribution to journalArticle

@article{2a55012fcf0f47e7a4bad1368063cc17,
title = "Comorbidity profiles and inpatient outcomes during hospitalization for heart failure: An analysis of the U.S. Nationwide inpatient sample",
abstract = "Background: Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.Methods: Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (n = 192,327).Results: Most discharges were characterized by {"}common{"} comorbidities. A {"}lifestyle{"} profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A {"}renal{"} profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A {"}neurovascular{"} profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15{\%} longer length of stay (LOS) and 12{\%} greater cost, the renal profile was associated with a 30{\%} higher risk of death, 27{\%} longer LOS and 24{\%} greater cost, and the neurovascular profile was associated with a 45{\%} higher risk of death, 34{\%} longer LOS and 37{\%} greater cost (all p <0.001).Conclusions: Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.",
keywords = "Comorbidity, Heart failure, Inpatient, Outcomes",
author = "Christopher Lee and Christopher Chien and Bidwell, {Julie T.} and Jill Gelow and Quin Denfeld and Creber, {Ruth M.} and Buck, {Harleah G.} and James Mudd",
year = "2014",
month = "6",
day = "5",
doi = "10.1186/1471-2261-14-73",
language = "English (US)",
volume = "14",
journal = "BMC Cardiovascular Disorders",
issn = "1471-2261",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Comorbidity profiles and inpatient outcomes during hospitalization for heart failure

T2 - An analysis of the U.S. Nationwide inpatient sample

AU - Lee, Christopher

AU - Chien, Christopher

AU - Bidwell, Julie T.

AU - Gelow, Jill

AU - Denfeld, Quin

AU - Creber, Ruth M.

AU - Buck, Harleah G.

AU - Mudd, James

PY - 2014/6/5

Y1 - 2014/6/5

N2 - Background: Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.Methods: Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (n = 192,327).Results: Most discharges were characterized by "common" comorbidities. A "lifestyle" profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A "renal" profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A "neurovascular" profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15% longer length of stay (LOS) and 12% greater cost, the renal profile was associated with a 30% higher risk of death, 27% longer LOS and 24% greater cost, and the neurovascular profile was associated with a 45% higher risk of death, 34% longer LOS and 37% greater cost (all p <0.001).Conclusions: Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.

AB - Background: Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.Methods: Latent mixture modeling was used to identify common profiles of comorbidities during adult hospitalizations for HF from the 2009 Nationwide Inpatient Sample (n = 192,327).Results: Most discharges were characterized by "common" comorbidities. A "lifestyle" profile was characterized by a high prevalence of uncomplicated diabetes, hypertension, chronic pulmonary disorders and obesity. A "renal" profile had the highest prevalence of renal disease, complicated diabetes, and fluid and electrolyte imbalances. A "neurovascular" profile represented the highest prevalence of cerebrovascular disease, paralysis, myocardial infarction and peripheral vascular disease. Relative to the common profile, the lifestyle profile was associated with a 15% longer length of stay (LOS) and 12% greater cost, the renal profile was associated with a 30% higher risk of death, 27% longer LOS and 24% greater cost, and the neurovascular profile was associated with a 45% higher risk of death, 34% longer LOS and 37% greater cost (all p <0.001).Conclusions: Comorbidity profiles are helpful in identifying adults at higher risk of death, longer length of stay, and accumulating greater costs during hospitalizations for HF.

KW - Comorbidity

KW - Heart failure

KW - Inpatient

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84902548274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902548274&partnerID=8YFLogxK

U2 - 10.1186/1471-2261-14-73

DO - 10.1186/1471-2261-14-73

M3 - Article

VL - 14

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

SN - 1471-2261

M1 - 73

ER -