Impact of Hospital Practice Factors on Mortality in Patients Hospitalized for Heart Failure in Japan ― An Analysis of a Large Number of Health Records From a Nationwide Claims-Based Database, the JROAD-DPC ―
Open Access
- 24 April 2020
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 84 (5), 742-753
- https://doi.org/10.1253/circj.cj-19-0759
Abstract
Background:An inverse relationship exists between hospital case volume and mortality in patients with heart failure (HF). However, hospital performance factors associated with mortality in HF patients have not been examined. We aimed to identify these using exploratory factor analysis and assess the relationship between these factors and 7-day, 30-day, and in-hospital mortality among HF patients in Japan. Methods and Results:We analyzed the records of 198,861 patients admitted to 683 certified hospitals of the Japanese Circulation Society between 2012 and 2014. Records were obtained from the nationwide database of the Japanese Registry Of All cardiac and vascular Diseases-Diagnostic Procedure Combination (JROAD-DPC). Using exploratory factor analysis, 90 hospital survey items were grouped into 5 factors, according to their collinearity: “Interventional cardiology”, “Cardiovascular surgery”, “Pediatric cardiology”, “Electrophysiology” and “Cardiac rehabilitation”. Multivariable logistic regression analysis was performed to determine the association between these factors and mortality. The 30-day mortality was 8.0%. Multivariable logistic regression analysis showed the “Pediatric cardiology” (odds ratio (OR) 0.677, 95% confidence interval [CI]: 0.628–0.729, PConclusions:Hospital factors, including various cardiovascular therapeutic practices, may be associated with the early death of HF patients.Keywords
This publication has 33 references indexed in Scilit:
- Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry)Circulation Journal, 2013
- Presence of Atrial Fibrillation Is Independently Associated With Adverse Outcomes in Patients Hospitalized With Heart FailureCirculation: Heart Failure, 2012
- Hospital Volume and 30-Day Mortality for Three Common Medical ConditionsThe New England Journal of Medicine, 2010
- Evolution of the coronary care unit: Clinical characteristics and temporal trends in healthcare delivery and outcomes*Critical Care Medicine, 2010
- Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort studyThe Lancet, 2009
- Effects of Atrial Fibrillation on Long-Term Outcomes in Patients Hospitalized for Heart Failure in Japan A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)Circulation Journal, 2009
- EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of populationEuropean Heart Journal, 2006
- Clinical Characteristics and Outcome of Hospitalized Patients With Heart Failure in Japan Rationale and Design of Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)Circulation Journal, 2006
- Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)American Heart Journal, 2005
- Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)BMJ, 2004