Heart failure hospitalizations in urban teaching hospitals were associated with higher odds of inpatient mortality compared to non-teaching hospitals (OR 1.19; 95% CI 1.16-1.22; p<0.001).
Observational (n=7,558,299)
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Does hospitalization in an urban teaching hospital compared to an urban non-teaching hospital improve outcomes in patients with heart failure?
Heart failure hospitalizations at urban teaching hospitals in the US are associated with higher inpatient mortality, complication rates, and resource utilization compared to non-teaching hospitals, even after propensity matching.
Odds Ratio: 1.19 (95% CI 1.16–1.22)
valor p: p=<0.001
Abstract Background Heart failure (HF) continues to be a major cause of morbidity and mortality worldwide, placing a significant burden on healthcare systems. Differences in the outcomes of HF hospitalizations for adults in teaching vs. non-teaching hospitals in urban settings are uncertain. We evaluated outcomes of HF hospitalizations in patients hospitalized in urban teaching vs. non-teaching hospitals in the United States. Methods HF hospitalizations were abstracted from the 2016 through 2022 Nationwide Readmissions Database and stratified into urban teaching vs. urban non-teaching hospital settings. Propensity-score matching was used to control for baseline differences between teaching and non-teaching hospital cohorts. Logistic regression and lognormal models were estimated to assess differences in inpatient mortality, length of stay (LOS), total costs, complications, and 30-day and 90-day all-cause readmissions. Results A total of 7,558,299 weighted HF hospitalizations were included in the analysis, of which 76.3% involved urban teaching hospitalizations. Compared to urban non-teaching, HF hospitalizations in urban teaching hospitals were associated with significantly higher odds of inpatient mortality (OR 1.19, 95% CI: 1.16-1.22), complications including cardiogenic shock, cardiac arrest, Intra-aortic balloon pump, cardiopulmonary resuscitation, extracorporeal membrane oxygenation and mechanical ventilation use as well as more extended hospital LOS, higher total costs, palliative care consultation and readmissions rates (all p0.001). 30-day and 90-day all-cause readmission rates were also statistically higher in teaching hospitals, though the difference was clinically non-significant. Conclusion HF hospitalizations in urban teaching hospitals were associated with higher inpatient mortality, complication rates, resource utilization, and palliative care consult rates than urban non-teaching hospitals.
Jabbar et al. (Wed,) conducted a observational in Heart failure (n=7,558,299). Urban teaching hospital admission vs. Urban non-teaching hospital admission was evaluated on Inpatient mortality (OR 1.19, 95% CI 1.16-1.22, p=<0.001). Heart failure hospitalizations in urban teaching hospitals were associated with higher odds of inpatient mortality compared to non-teaching hospitals (OR 1.19; 95% CI 1.16-1.22; p<0.001).