V体育平台登录 - Ten-year trends in hospital care for congestive heart failure: improved outcomes and increased use of resources
- PMID: 10668834
- DOI: 10.1001/archinte.160.3.325
V体育平台登录 - Ten-year trends in hospital care for congestive heart failure: improved outcomes and increased use of resources
Abstract
Background: Scarce data are available on long-term trends in hospital mortality, length of stay (LOS), and costs in congestive heart failure (CHF). VSports手机版.
Objective: To assess 10-year trends in the outcomes of patients hospitalized with CHF V体育安卓版. .
Methods: We studied all 6676 patients with a primary discharge diagnosis of CHF hospitalized from January 1, 1986, through July 31, 1996, at an academic tertiary care center V体育ios版. Hospital mortality, LOS, and costs were adjusted for sociodemographic characteristics, comorbidities, invasive procedures, hospital disposition, and LOS where appropriate. .
Results: The mean (+/- SD) age of patients was 70+/-13 years; 54. 1% were male; 87. 0% were white. There was a significant increasing trend in heart failure severity as assessed by a CHF-specific risk-adjustment index. The proportion of patients who underwent invasive procedures (e. g VSports最新版本. , cardiac catheterization, coronary angioplasty, coronary artery bypass surgery, defibrillator and pacemaker implantation) was significantly higher in the 1994-1996 period. The standardized mortality ratio (observed mortality/predicted mortality) progressively fell during the study period. Compared with patients admitted before 1991, those admitted after 1991 had a 24% lower observed than predicted mortality. Adjusted LOS exhibited a downward trend, ie, 7. 7 days in 1986-1987 to 5. 6 days in 1994-1996 (P<. 001). Unadjusted cost peaked during 1992-1993 and declined thereafter. Adjusted costs in 1994-1996 were not significantly different from those in 1990-1991. .
Conclusions: After risk adjustment for sociodemographic characteristics, comorbidities, and disease severity, a significant decrease in in-hospital mortality was observed during the study decade. This decline in hospital mortality occurred in parallel with decreasing LOS and increasing use of cardiac procedures and costs. V体育平台登录.
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