Table 2.
Patient characteristics summarized at the hospital level and stratified by quartiles of risk-standardized hospital rates of inotrope use.
| Patient Variable summarized at Hospital Lever | Q1 | Q2 | Q3 | Q4 | P-value |
|---|---|---|---|---|---|
| Low Use Hospitals | High Use Hospitals | ||||
| N=52 (Patients 29,336) | N=52 (Patients 31,582) | N=53 (Patients 34,551) | N=52 (Patients 31,095) | ||
| Patient Demographics | |||||
| Age, hospital median of mean years (IQR) | 77 (73–80) | 77 (73–80) | 78 (74–81) | 75 (72–78) | 0.11 |
| Female, median hospital percent (IQR) | 52.0% (48.5–58.9) | 51.8% (47.3–58.2) | 51.2% (46.2–55.2) | 48.4% (43.3–52.0)% | 0.0021 |
| Race, hospital median percent (IQR) | |||||
| White | 85.6% (59.2–95.8)% | 85.1% (61.6–93.8) | 82.5% (57.7–93.7) | 74.7% (57.8–86.6) | 0.081 |
| Black | 4.6% (1.2–30.5) | 8.5% (0.8–19.7) | 4.4% (0.9–12.0) | 8.6% (1.0–26.6) | 0.77 |
| Other | 3.6% (1.5–11.2) | 2.9% (0.9–7.0) | 5.2% (1.2–15.6) | 6.5% (1.6–14.4) | 0.15 |
| Health Insurance Status, median hospital percent (IQR) | |||||
| Medicare | 56.3% (29.7–79.6) | 53.4% (35.9–74.5) | 48.9% (20.6–67.6) | 59.3% (26.2–76.7 | 0.64 |
| Medicaid | 5.3% (1.9–11.4) | 7.0% (2.8–14.6) | 6.0% (3.0–14.0) | 5.4% (3.3–12.6) | 0.89 |
| Private/other | 21.4% (8.1–41.1) | 19.1% (8.3–38.9) | 20.8% (12.0–32.4) | 20.8% (10.3–35.7) | 0.98 |
| None or undetermined | 2.1% (0.5–4.2) | 1.7% (0.3–4.6) | 1.8% (0.5–3.6) | 1.9% (0.8–5.1) | 0.82 |
| Cardiac History, median hospital percent (IQR) | |||||
| Heart failure, prior diagnosis | 55.5% (32.3–66.2) | 62.2% (43.4–73.7) | 58.9% (36.5–70.3) | 63.7% (45.9–74.2) | 0.34 |
| Ischemic heart disease | 52.8% (45.4–58.0) | 55.0% (47.5–66.5) | 55.4% (50.4–60.9) | 54.6% (47.5–59.6) | 0.47 |
| Valve disease | 5.4% (3.2–15.0) | 10.2% (4.0–17.0) | 12.4% (6.7–21.4) | 12.3% (4.7–19.5) | 0.018 |
| ICD or CRT-D | 7.4% (4.6–14.2) | 9.3% (5.5–12.6) | 10.6% (5.2–14.4) | 11.1% (7.3–17.9) | 0.087 |
| Atrial fibrillation or flutter | 28.3% (22.6–39.2) | 35.5% (24.8–42.2) | 36.1% (27.5–41.2) | 33.2% (23.2–42.9) | 0.31 |
| Beta-blocker at admission | 38.8% (0.0–57.6) | 49.6% (11.0–66.3) | 49.0% (20.8–66.0) | 56.6% (10.8–67.6) | 0.34 |
| Medical History, median hospital percent (IQR) | |||||
| Diabetes | 41.5% (36.9–47.9) | 43.0% (37.3–47.7) | 40.7% (38.1–45.4) | 41.0% (34.5–45.2) | 0.81 |
| Hypertension | 71.7% (66.9–77.7) | 76.1% (69.7–81.5) | 76.8% (65.4–81.5) | 72.0% (63.4–78.6) | 0.084 |
| Hyperlipidemia | 36.5% (27.4–44.4) | 43.2% (33.5–52.7) | 41.7% (34.6–49.1) | 38.8% (25.3–47.4) | 0.065 |
| Peripheral vascular disease | 8.7% (4.3–12.9) | 13.0% (7.9–18.2) | 12.1% (7.7–17.2) | 9.1% (5.2–13.2) | 0.0059 |
| CVA/TIA | 13.4% (9.7–16.2) | 15.3% (10.6–19.4) | 13.8% (10.7–16.2) | 12.2% (7.8–15.3) | 0.054 |
| Renal insufficiency, no dialysis | 16.3% (12.4–21.0) | 16.5% (12.5–22.3) | 19.1% (15.6–23.0) | 16.3% (11.4–22.5) | 0.33 |
| Renal insufficiency, dialysis | 2.3% (0.3–4.0) | 1.8% (0.0–4.2) | 2.2% (0.0–4.4) | 2.2% (1.1–3.5) | 0.94 |
| Anemia | 15.7% (7.5–23.2) | 21.0% (13.4–28.0) | 16.1% (11.1–24.1) | 16.2% (10.1–21.8) | 0.071 |
| COPD or asthma | 28.3% (23.7–32.4) | 32.2% (25.8–36.3) | 29.2% (22.4–36.6) | 29.4% (22.1–24.9) | 0.25 |
| Smoking | 14.6% (11.4–19.7) | 16.8% (107–19.9) | 12.3% (7.7–17.7) | 16.7% (10.5–18.7) | 0.062 |
| Depression | 7.3% (4.3–13.7) | 10.7% (6.5–15.8) | 9.1% (4.9–12.3) | 7.8% (3.9–11.3) | 0.042 |
| Measurements Closest to Admission, median hospital median (IQR) | |||||
| Systolic blood pressure, mmHg | 138 (135–142) | 139 (135–142) | 139 (134–140) | 138 (133–140) | 0.59 |
| Heart rate, bpm | 83 (80–85) | 82 (80–85) | 82 (80–84) | 82 (80–85) | 0.83 |
| Body mass index, kg/m2 | 28.3 (24.0–34.3) | 28.3 (24.0–34.0) | 28.2 (24.0–34.0) | 28.3 (24.2–34.3) | 0.024 |
| Left ventricular ejection fraction | 0.45 (0.36–0.50) | 0.45 (0.40–0.45) | 0.45 (0.38–0.47) | 0.40 (0.35–0.45) | 0.80 |
| Serum sodium, mmol/L | 138 (138–139) | 138 (137–139) | 138 (138–139) | 138 (137–139) | 0.26 |
| Serum creatinine, mg/dL | 1.3 (1.2–1.4) | 1.3 (1.3–1.4) | 1.3 (1.2–1.4) | 1.3 (1.2–1.4) | 0.99 |
| Blood urea nitrogen, mg/dL | 25 (23–26) | 25 (23–26) | 26 (24–28) | 26 (23–27) | 0.0058 |
| Hemoglobin, g/dL | 11.9 (11.7–12.2) | 11.8 (11.6–12.3) | 11.9 (11.7–12.1) | 12.0 (11.6–12.3) | 0.89 |
Q=quartile; IQR=interquartile range; ICD=implantable cardioverter-defibrillator; CRT-D=cardiac resynchronization therapy with implantable cardioverter-defibrillator; CVA=cerebrovascular accident; TIA=transient ischemic attack; COPD=chronic obstructive pulmonary disease; mmHg=millimeters mercury; bpm=beats per minute; BNP=b-type natriuretic peptide.
P-values calculated by comparing only non-missing values. All tests treat the column variable as ordinal.
Missing data: body mass index 18.9%; left ventricular ejection fraction 4.1%; sodium 15.2%; Cr 13.6%; BUN 15.0%; HgB 16.2%; BNP 31.8%.