Heart failure patients who are hospitalized in higher-performing hospitals, based on 30-day risk-standardized mortality rates (RSMR), may have better long-term survival, according to findings from an analysis of data from the Get With the Guidelines-Heart Failure (GWTG-HF) registry. The results were presented Monday, March 12 at ACC.18 in Orlando, FL. The study was published simultaneously in JAMA Cardiology.

The analysis, led by Ambarish Pandey, MD, evaluated the association between hospital performance, based on 30-day RSMR, and long-term survival in 106,304 HF patients older than 65 who were hospitalized in one of 317 GWTG-HF participating centers between January 1, 2005 and December 31, 2013. Medicare-linked data was available for all participants. The study assessed 30-day RMSR and five-year all-cause mortality.

According to the results, high-performing hospitals had a long-term mortality rate of 75.6 percent vs. 79.6 percent for low-performing hospitals. Median survival in the high-performing vs. low-performing hospitals was 717 days vs. 579 days.

In an adjusted analysis, the five-year mortality rate in the lowest-performing hospitals was 22 percent higher than in the highest-performing hospitals. In addition, the 30-day RSMR ranged from 8.6 percent in the highest-performing quartile of hospitals to 10.7 percent in the lowest-performing quartile. Based on the findings, the researchers concluded that 30-day RSMR may be a useful metric to incentivize quality and improve long-term outcomes.

Keywords: ACC18, ACC Annual Scientific Session, Heart Failure, Logistic Models, Proportional Hazards Models, Medicare, Hospitalization, Heart Failure, Survivors

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