EFFECT OF TEACHING HOSPITAL STATUS ON HEART FAILURE OUTCOMES: ANALYSIS OF THE NATIONAL INPATIENT SAMPLE 2021

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

hypertensive factor, aged, blood transfusion, cardiogenic shock, conference abstract, heart disease, heart failure, human, ICD-10, incidence, intensive care unit, major clinical study, male, mortality, mortality rate, teaching hospital, United States

Abstract

Background: Heart failure is a growing concern in the U.S., affecting nearly 6.5 million Americans aged 20 and older, with over 960,000 new cases diagnosed annually. It contributes to 8.5% of heart disease-related deaths. Previous research has explored the impact of teaching hospital (TH) status on outcomes across various diseases. This study aimed to determine whether TH status influenced outcomes for heart failure patients. Methods Data were drawn from the 2021 National Inpatient Sample, including 6,666,752 admissions. After filtering for heart failure (ICD10 I50), 16,519 patients remained. Exclusions included 3,444 rural nonteaching hospital (NTH) admissions. The final cohort included 3,402 urban NTH and 13,117 urban TH admissions. Chi-square and logistic regression analyzed mortality, cardiogenic shock, ICU admission, AKI, vasopressor use, and blood transfusion, with TH status as the independent variable. Results The study analyzed 16,519 patients with a mortality rate of 3.81%. Mortality was higher in THs (4.05%) than NTHs (2.88%) (p 0.002). Cardiogenic shock occurred in 7.77%, more in THs (9.13%) than NTHs (2.50%) (p 0.001). ICU admission was higher in THs (3.35%) than NTHs (1.52%) (p 0.001). AKI incidence was 29.01%, higher in THs (30.80%) than NTHs (22.10%) (p 0.001). Vasopressor use occurred in 2.81% of patients overall, more in THs (3.26%) than NTHs (1.06%) (p 0.001). Blood transfusions were higher in THs (2.59%) than NTHs (1.73%) (p 0.004). Conclusion Significant differences exist in outcomes between THs and NTHs for heart failure patients, with THs showing more severe presentations, evidenced by higher mortality, cardiogenic shock, ICU admission, AKI, vasopressor use, and transfusions.

Volume

85

Issue

12

First Page

1572

Share

COinS