Effect of gender, ethnicity, pulmonary disease, and symptom stability on rehospitalization in patients with heart failure

被引:46
作者
Howie-Esquivel, Jill [1 ]
Dracup, Kathleen [1 ]
机构
[1] Univ San Francisco, Dept Physiol Nursing, San Francisco, CA 94117 USA
关键词
D O I
10.1016/j.amjcard.2007.04.061
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Predicting rehospitalization risk may enable more tailored therapies for. patients at high risk of rehospitalization. The objective of this study was to determine whether demographic,, clinical, or psychological variables conferred increased risk of rehospitalization in a multiethnic, hospitalized, heart failure (HF) population. Demographic and clinical data were collected, with psychological and functional (6-minute walk test [6MWT]) variables obtained within 48 hours of discharge. Patients with, HF (n = 72) were followed up for 90 days after discharge. Subjects ' mean age was 62 +/- 18 years, with almost 1/2 nonwhite (n = 32) and 2/3 men (n = 47). Mean discharge brain natriuretic peptide was 825 +/- 716 ng/L, mean quality-of-life score was 34 +/- 21, and mean 6MWT distance was 186 +/- 99 m. Almost 1/2 (n = 34) were rehospitalized for cardiac reasons within 90 days. Women had a 2.5 times greater risk for rehospitalization than men. Both female gender and nonwhite ethnicity incurred 2 2 times greater risk of cardiac rehospitalization. Brain natriuretic peptide and 6MWT score did not predict rehospitalization risk. In conclusion, sociodemographic factors may be more powerful predictors of rehospitalization than known clinical markers in multiethnic patients hospitalized for HF. Evaluation for support services is needed to prevent rehospitalization, especially in women and nonwhites. (C) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:1139 / 1144
页数:6
相关论文
共 22 条
[1]   Congestive heart failure hospitalizations and survival in California: Patterns according to race ethnicity [J].
Alexander, M ;
Grumbach, K ;
Remy, L ;
Rowell, R ;
Massie, BM .
AMERICAN HEART JOURNAL, 1999, 137 (05) :919-927
[2]   Determining prognosis in congestive heart failure: Role of the 6-minute walk test [J].
Bittner, V .
AMERICAN HEART JOURNAL, 1999, 138 (04) :593-596
[3]   The association of 6-minute walk performance and outcomes in stable outpatients with heart failure [J].
Curtis, JP ;
Rathore, SS ;
Wang, YF ;
Krumholz, HM .
JOURNAL OF CARDIAC FAILURE, 2004, 10 (01) :9-14
[4]   Impact of race on health care utilization and outcomes in veterans with congestive heart failure [J].
Deswal, A ;
Petersen, NJ ;
Souchek, J ;
Ashton, CM ;
Wray, NP .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (05) :778-784
[5]   Racial differences in treatment-seeking delays among heart failure patients [J].
Evangelista, LS ;
Dracup, K ;
Doering, LV .
JOURNAL OF CARDIAC FAILURE, 2002, 8 (06) :381-386
[6]   Race, ethnicity, and heart failure [J].
Ghali, JK .
JOURNAL OF CARDIAC FAILURE, 2002, 8 (06) :387-389
[7]   Process of care in Hispanic, black, and white VA beneficiaries [J].
Gordon, HS ;
Johnson, ML ;
Ashton, CM .
MEDICAL CARE, 2002, 40 (09) :824-833
[8]   Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: A new health status measure for heart failure [J].
Green, CP ;
Porter, CB ;
Bresnahan, DR ;
Spertus, JA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (05) :1245-1255
[9]  
GUYATT GH, 1985, CAN MED ASSOC J, V132, P919
[10]   The expanding national burden of heart failure in the United States: The influence of heart failure in women [J].
Koelling, TM ;
Chen, RS ;
Lubwama, RN ;
L'Italien, GJ ;
Eagle, KA .
AMERICAN HEART JOURNAL, 2004, 147 (01) :74-78