Abstract 14519: Assessing Competing Risks for 30-Day Outcomes Following Acute Heart Failure Hospitalizations Using Real World Data
Introduction: Individual risk factors may differentially predict outcomes following acute heart failure (HF) hospitalization. We assessed competing risks for 30-day outcomes using an approach that simultaneously models all outcomes to evaluate the relative influence of each risk factor.
Methods: We identified patients hospitalized for HF between 2008 and 2012 in a large administrative database (Truven Health MarketScan® Database). Thirty-day outcomes were in-hospital mortality, all-cause readmission, length of stay (LOS) >10 days and the end of enrollment in the health plan (unknown vital status). Competing risks analyses were conducted using multinomial logistic regression adjusting for demographics and other patient characteristics.
Results: A total of 97,102 patients with an acute HF hospitalization were identified during the study period. The mean age was 74.2 (SD=13.7) and 53.5% of patients were male. Twenty percent of patients experienced one of the 4 outcomes within 30 days: 2.3% in-hospital deaths, 7.4% readmission, 6.7% LOS>10 and 3.7% had an end of enrollment. Acute events occurring during the hospitalization were differentially associated with 30 day outcomes, with acute respiratory failure and renal failure occurring most frequently prior to in-hospital death and a prolonged LOS (Figure 1). Chronic risk factors such as diabetes and hypertension, also had a differential association with 30-day outcomes (Table 1).
Conclusions: Using an approach that simultaneously models risk for multiple outcomes, we observed marked differences in the relative impact of various risk factors in mediating the risk of 30-day outcomes in patients hospitalized for acute HF.
Author Disclosures: E. Nkhoma: Employment; Significant; Bristol-Myers Squibb. C. Russo: Employment; Significant; Bristol-Myers Squibb. Z. Guo: Employment; Significant; Bristol-Myers Squibb.
- © 2016 by American Heart Association, Inc.