Table 3.
Logistic regression models for mortality.
| Died in index hospitalization OR (95% CI) |
One year mortality+ OR (95% CI) |
Cardiac-specific one-year mortality OR (95% CI) |
||||
|---|---|---|---|---|---|---|
|
Primary predisposing individual variables |
||||||
| No mental illness | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| Dementia only | 2.09 (1.54–2.83) | c | 1.19 (0.94–1.51) | 1.10 (0.76–1.59) | ||
| Dementia plus any other mental illness |
1.74(1.13–2.70) | b | 0.80(0.57–1.12) | 0.82(0.47–1.44) | ||
| Serious mental illness (SMI) only | 1.44 (0.92–2.27) | 1.27 (0.93–1.74) | 1.46 (0.91–2.34) | |||
| SMI plus depression and/or anxiety | 1.00 (0.54–1.86) | 0.98 (0.66–1.46) | 1.09 (0.58–2.05) | |||
| Depression only | 1.18 (0.86–1.61) | 1.30 (1.07–1.59) | b | 1.37 (1.02–1.85) | a | |
| Anxiety only | 0.86 (0.51–1.43) | 1.27 (0.95–1.72) | 1.18 (0.74–1.88) | |||
| Depression and anxiety | 0.71 (0.36–1.40) | 0.74 (0.48–1.15) | 0.83 (0.42–1.62) | |||
| Other mental illness | 1.53 (1.02–2.31) | a | 1.41 (1.06–1.88) | a | 1.22 (0.77–1.93) | |
|
Other predisposing individual variables |
||||||
| Less than 65 years of age | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| 65 to 74 years | 1.55 (1.19–2.02) | b | 1.13 (0.95–1.34) | 1.05 (0.81–1.37) | ||
| 75 to 79 years | 1.44 (1.06–1.96) | a | 1.21 (1.00–1.48) | 1.16 (0.85–1.57) | ||
| 80+ years | 1.91 (1.41–2.58) | c | 1.27 (1.04–1.56) | a | 1.06 (0.77–1.46) | |
| White | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| Black | 0.73 (0.57–0.93) | a | 0.81 (0.69–0.94) | b | 0.75 (0.59–0.96) | a |
| Other race | 0.82 (0.59–1.16) | 0.84 (0.70–1.04) | 0.79 (0.55–1.15) | |||
| Female | 1.00 (0.50–1.96) | 1.07 (0.69–1.65) | 0.58 (0.23–1.44) | |||
| Married | 0.98 (0.83–1.15) | 1.18 (1.06–1.33) | b | 1.24 (1.04–1.48) | a | |
| Homeless | 1.42 (0.97–2.10) | 0.67 (0.52–0.86) | b | 0.62 (0.40–0.96) | a | |
| Substance Use/Abuse | 1.04 (0.82–1.32) | 0.95 (0.81–1.11) | 1.04 (0.82–1.31) | |||
| Service-Connected (SC) condition>10% |
1.15 (0.95–1.39) | 1.28 (1.12–1.46) | c | 0.97 (0.79–1.20) | ||
| Enabling contextual | ||||||
| Metro County, greater than 1,000,000 | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| Metro County, less than 1,000,000 | 1.29 (0.98–1.69) | 0.75 (0.62–0.91) | b | 0.76 (0.56–1.03) | ||
| Non-Metro County | 1.18 (0.90–1.55) | 0.68 (0.56–0.82) | c | 0.75 (0.56–1.00) | ||
| VAMC has no medical school affiliation |
4.16 (0.34–51.62) | 2.18 (0.38–12.39) | 20.64 (0.62–68.72) | |||
| # of veterans served in Fiscal Year 01 (1,000’s) |
1.07 (0.66–1.72) | 1.10 (0.78–1.54) | 1.45 (0.67–3.11) | |||
| Individual need variables | ||||||
| CHF Index | ||||||
| 1 | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| 2 | 1.81 (1.29–2.53) | b | 1.61 (1.33–1.94) | c | 1.28 (0.96–1.69) | |
| 3 | 2.75 (1.90–3.98) | c | 1.98 (1.59–2.46) | c | 1.66 (1.20–2.31) | b |
| 4 | 5.01 (3.33–7.54) | c | 2.27 (1.73–2.98) | c | 1.59 (1.04–2.42) | a |
| 5 | 9.01 (5.78–14.04) | c | 1.88 (1.32–2.68) | b | 1.00 (0.54–1.84) | |
| 6 | 13.79 (9.23–20.61) | c | 1.84 (1.32–2.57) | c | 1.61 (0.97–2.67) | |
| Elixhauser comorbidities | ||||||
| Peripheral vascular disorders | 0.87 (0.64–1.19) | 1.40 (1.17–1.68) | c | 1.23 (0.93–1.64) | ||
| Chronic pulmonary disease | 0.88 (0.72–1.07) | 0.88 (0.76–1.01) | 1.01 (0.81–1.25) | |||
| Diabetes (no complications) | 0.96 (0.80–1.16) | 1.12 (1.00–1.26) | 1.13 (0.94–1.36) | |||
| Diabetes (with complications) | 0.97 (0.68–1.40) | 1.38 (1.10–1.73) | b | 1.50 (1.07–2.09) | b | |
| Hyperthyroidism | 0.65 (0.45–0.93) | a | 1.29 (1.04–1.60) | a | 1.59 (1.17–2.17) | b |
| Renal failure | 1.55 (1.19–2.02) | b | 1.13 (0.89–1.42) | 1.27 (0.90–1.79) | ||
| Cancer (tumor) | 0.87 (0.63–1.21) | 1.21 (0.98–1.49) | 0.73 (0.50–1.07) | |||
| Fluid and electrolyte disorders | 1.65 (1.33–2.05) | c | 0.83 (0.68–1.01) | 0.72 (0.52–0.99) | a | |
| Deficiency anemia | 0.79 (0.63–0.99) | a | 1.06 (0.92–1.22) | 1.03 (0.83–1.29) | ||
| Hypertension | 0.51 (0.43–0.62) | c | 0.84 (0.75–0.94) | b | 0.79 (0.66–0.94) | b |
| Obesity | 1.00 (0.65–1.54) | 0.64 (0.47–0.86) | b | 0.58 (0.35–0.94) | a | |
| Prior CHF hospitalization | 2.41 (2.02–2.88) | a | 1.33 (1.17–1.51) | c | 1.24 (1.01–1.51) | a |
| Index hospitalization length of stay (log) |
N/A | 1.12 (1.05–1.20) | b | 1.08 (0.97–1.19) | ||
| Health care utilization+ | ||||||
| 0 primary care visits | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) | |||
| 1 to 4 primary care visits | 0.66 (0.48–0.93) | a | 0.61 (0.53–0.71) | c | 0.96 (0.76–1.22) | |
| 5 to 8 primary care visits | 0.73 (0.52–1.02) | 0.29 (0.25–0.35) | c | 0.48 (0.36–0.63) | c | |
| 9 to 15 primary care visits | 0.66 (0.47–0.93) | a | 0.20 (0.16–0.24) | c | 0.24 (0.17–0.34) | c |
| 16 or more visits | 0.62 (0.43–0.89) | b | 0.11 (0.09–0.14) | c | 0.17 (0.11–0.25) | c |
| Any mental health visits | 0.96 (0.73–1.25) | 0.70 (0.58–0.85) | c | 0.66 (0.48–0.90) | a |
a
p<0.05,
b
p< 0.01,
c
p<0.001
+
For index mortality, utilization is for year preceding admission. For one-year mortality, utilization is for year following discharge among those discharged alive.