Table 5.
Adjusted Associations* of Study Group With Modified Study Group Definitions and 30‐Day and 1‐Year Outcomes
| Outcome | Modified Definition 1 (Early IV Nitroglycerin Use Not Considered a Complicated Presentation) | Modified Definition 2 (Any Early IV Vasodilator Use Not Considered a Complicated Presentation) | ||
|---|---|---|---|---|
| Hazard Ratio (99% CI) | P Value | Hazard Ratio (99% CI) | P Value | |
| Mortality at 30 days* | ||||
| Worsening heart failure vs uncomplicated course | 2.61 (2.39 to 2.85) | <0.001 | 2.70 (2.48 to 2.94) | <0.001 |
| Complicated presentation vs uncomplicated course | 2.07 (1.90 to 2.26) | <0.001 | 2.20 (1.99 to 2.43) | <0.001 |
| Worsening heart failure vs complicated presentation | 1.26 (1.14 to 1.39) | <0.001 | 1.23 (1.10 to 1.37) | <0.001 |
| Mortality at 1 year* | ||||
| Worsening heart failure vs uncomplicated course | 1.67 (1.59 to 1.75) | <0.001 | 1.69 (1.62 to 1.76) | <0.001 |
| Complicated presentation vs uncomplicated course | 1.39 (1.33 to 1.46) | <0.001 | 1.43 (1.35 to 1.52) | <0.001 |
| Worsening heart failure vs complicated presentation | 1.20 (1.13 to 1.27) | <0.001 | 1.18 (1.10 to 1.27) | <0.001 |
| All‐cause readmission at 30 days* | ||||
| Worsening heart failure vs uncomplicated course | 1.24 (1.15 to 1.35) | <0.001 | 1.24 (1.15 to 1.34) | <0.001 |
| Complicated presentation vs uncomplicated course | 1.10 (1.04 to 1.17) | <0.001 | 1.12 (1.05 to 1.19) | <0.001 |
| Worsening heart failure vs complicated presentation | 1.13 (1.04 to 1.22) | <0.001 | 1.11 (1.02 to 1.21) | <0.001 |
| All‐cause readmission at 1 year* | ||||
| Worsening heart failure vs uncomplicated course | 1.11 (1.06 to 1.17) | <0.001 | 1.11 (1.06 to 1.16) | <0.001 |
| Complicated presentation vs uncomplicated course | 1.07 (1.04 to 1.11) | <0.001 | 1.07 (1.02 to 1.11) | <0.001 |
| Worsening heart failure vs complicated presentation | 1.03 (0.98 to 1.09) | 0.47 | 1.04 (0.98 to 1.10) | 0.07 |
Covariates in the adjusted regression models are the same as in Table 4 and included demographic characteristics (age, sex, and race); medical history (anemia, atrial fibrillation, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease or asthma, diabetes mellitus, heart failure hospitalization in the past 6 months, hyperlipidemia, hypertension, peripheral vascular disease, prior myocardial infarction prior stroke or transient ischemic attack, smoking status, pacemaker type, and implantable cardioverter defibrillator); initial evaluation results, vital signs, and laboratory test results (dyspnea, ejection fraction, fatigue, hemoglobin level, pulmonary edema, pulse, rales, serum creatinine level, serum sodium level, and systolic blood pressure); medications (angiotensin‐converting inhibitor or angiotensin II receptor blocker, aspirin, β‐blocker, clopidogrel, diuretic, lipid‐lowering agent, warfarin); and the year of the index hospitalization. The mortality models included medication information from admission; the other models included medication information from discharge.
Includes all patients.
Excludes patients who died in the hospital, left against medical advice, were discharged, or transferred to another short‐term hospital or hospice.