Why the study?
Does African American race affect short- and long-term mortality in elderly patients hospitalized for heart failure compared to White race?
Does African American race affect short- and long-term mortality in elderly patients hospitalized for heart failure compared to White race?
Initial short-term survival advantages observed in elderly African American patients hospitalized for heart failure compared to White patients are attenuated over time and by adjusting for clinical covariates such as DNR orders.
Short-term racial mortality differences in elderly HF patients should not guide care; leaves open whether race independently predicts outcomes after adjustment.
Several studies have examined predictors of mortality among elderly patients hospitalized with heart failure. In some, elderly African American patients hospitalized for heart failure were reported to have lower risk-adjusted in-hospital mortality compared with Whites. Whether this difference is sustained in the long term and what factors account for this difference remain poorly understood. The objective of this study was to compare risk-adjusted short-term and long-term mortality of a cohort of elderly African American and White patients hospitalized for heart failure to all 30 hospitals in northeast Ohio. The database used for this analysis includes information on demographics and detailed clinical information abstracted from patients’ hospital records. Crude and adjusted 30-day and 18-month survival were compared using Kaplan-Meier method and logistic regression models for multivariate analysis. African American patients had significantly lower 30-day mortality compared with Whites. However, this difference diminished over time and when adjusted for important explanatory covariates, including “do not resuscitate” orders.
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Ibrahim et al. (2001) studied this question.
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