Table 1. Patient Characteristics by Quartiles of Hospital Risk-Standardized Echocardiography Ratesa.
| Variable | No. | ||||
|---|---|---|---|---|---|
| Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | Absolute Standardized Difference (Quartile 4 vs Quartile 1) | |
| Risk-standardized echocardiography rate | NA | ||||
| Median (range) | 54.0 (3.2-62.5) | 66.8 (62.6-72.4) | 75.7 (72.5-79.1) | 83.2 (79.1-94.3) | |
| Mean (SD) | 48.3 (15.8) | 67.3 (3.0) | 75.7 (1.9) | 83.9 (3.7) | |
| Patients | 20 728 (20.9) | 30 342 (30.6) | 22 102 (22.3) | 25 827 (26.1) | |
| Age | |||||
| Mean (SD), y | 66.5 (13.6) | 66.7 (13.7) | 67.1 (13.7) | 65.7 (13.5) | 5.77 |
| Median (IQR), y | 66 (57-77) | 67 (57-78) | 67 (57-78) | 66 (56-76) | |
| Female sex | 8192 (39.5) | 11 605 (38.2) | 8600 (38.9) | 9454 (36.6) | 6.01 |
| Race/ethnicity | |||||
| White | 14 868 (71.7) | 22 202 (73.2) | 13 081 (59.2) | 19 415 (75.2) | 9.96 |
| Black | 2770 (13.4) | 2999 (9.9) | 1807 (8.2) | 2691 (10.4) | |
| Hispanic | 867 (4.2) | 2182 (7.2) | 2158 (9.8) | 1171 (4.5) | |
| Other | 2223 (10.7) | 2959 (9.8) | 5056 (22.9) | 2550 (9.9) | |
| Insurance payer | |||||
| Medicare | 12 288 (59.3) | 17 510 (57.7) | 12 586 (56.9) | 14 606 (56.6) | 13.91 |
| Medicaid | 1321 (6.4) | 2543 (8.4) | 2288 (10.4) | 2442 (9.5) | |
| Managed care | 3983 (19.2) | 5990 (19.7) | 4468 (20.2) | 4622 (17.9) | |
| Commercial indemnity | 999 (4.8) | 1748 (5.8) | 1027 (4.6) | 1529 (5.9) | |
| Self-pay | 1343 (6.5) | 1489 (4.9) | 908 (4.1) | 1439 (5.6) | |
| Other | 794 (3.8) | 1062 (3.5) | 825 (3.7) | 1189 (4.6) | |
| Gagne Combined Comorbidity score | |||||
| Mean (SD) | 2.1 (2.7) | 2.0 (2.7) | 2.0 (2.7) | 2.0 (2.7) | 3.25 |
| Median (IQR) | 1 (0-4) | 1 (0-4) | 1 (0-4) | 1 (0-4) | |
| Comorbiditiesb | |||||
| Hypertension | 16 504 (79.6) | 24 122 (79.5) | 17 541 (79.4) | 20 423 (79.1) | 1.35 |
| Hypothyroidism | 8284 (40.0) | 11 961 (39.4) | 92 35 (41.8) | 10 345 (40.1) | 0.18 |
| Congestive heart failure | 6638 (32.0) | 9517 (31.4) | 7249 (32.8) | 8097 (31.4) | 1.45 |
| Chronic obstructive pulmonary disease | 4931 (23.8) | 6789 (22.4) | 4844 (21.9) | 6069 (23.5) | 0.68 |
| Renal failure | 4393 (21.2) | 6386 (21.0) | 4948 (22.4) | 5311 (20.6) | 1.55 |
| Obesity | 3872 (18.7) | 5768 (19.0) | 3885 (17.6) | 4941 (19.1) | 1.15 |
| Deficiency anemia | 3657 (17.6) | 5423 (17.9) | 4168 (18.9) | 4461 (17.3) | 0.98 |
| Valvular disease | 3053 (14.7) | 4971 (16.4) | 3325 (15.0) | 3894 (15.1) | 0.98 |
| Diabetes | 2574 (12.4) | 3541 (11.7) | 2670 (12.1) | 3254 (12.6) | 0.55 |
| Peripheral vascular disease | 2814 (13.6) | 4043 (13.3) | 2623 (11.9) | 3379 (13.1) | 1.45 |
| Depression | 1970 (9.5) | 2882 (9.5) | 1754 (7.9) | 2478 (9.6) | 0.31 |
| Other neurological disorders | 1452 (7.0) | 2060 (6.8) | 1353 (6.1) | 1622 (6.3) | 2.91 |
| Pulmonary circulation disease | 1212 (5.8) | 1950 (6.4) | 1329 (6.0) | 1535 (5.9) | 0.41 |
| Critical care therapies | |||||
| Intensive/Intermediate care unit, d | 10 593 (51.1) | 15 542 (51.2) | 12 384 (56.0) | 15 447 (59.8) | 17.58 |
| Median (IQR) | 2 (1-4) | 2 (1-4) | 2 (1-4) | 2 (1-4) | |
| Mean (SD) | 3.2 (3.7) | 3.2 (4.1) | 3.4 (4.3) | 3.5 (4.5) | 8.80 |
| Vasodilators | 7622 (36.8) | 12 031 (39.7) | 7466 (33.8) | 10 620 (41.1) | 8.93 |
| Noninvasive ventilation | 1528 (7.4) | 2548 (8.4) | 1787 (8.1) | 2242 (8.7) | 4.82 |
| Invasive mechanical ventilation | 2957 (14.3) | 5141 (16.9) | 3133 (14.2) | 4252 (16.5) | 6.10 |
| Vasopressors | 3799 (18.3) | 5997 (19.8) | 4066 (18.4) | 5729 (22.2) | 9.60 |
| Arterial line | 858 (4.1) | 1712 (5.6) | 800 (3.6) | 739 (2.9) | 6.96 |
| Intra-aortic balloon pump | 861 (4.2) | 1330 (4.4) | 1088 (4.9) | 1120 (4.3) | 0.91 |
| Inotropes | 2199 (10.6) | 3135 (10.3) | 2130 (9.6) | 2981 (11.5) | 2.97 |
| Other cardiac tests/therapies | |||||
| Nuclear imaging | 755 (3.6) | 1420 (4.7) | 1223 (5.5) | 1345 (5.2) | 7.62 |
| Ventriculography | 23 (0.1) | 73 (0.2) | 177 (0.8) | 1414 (5.5) | 32.99 |
| Cardiac magnetic resonance imaging | 65 (0.3) | 110 (0.4) | 54 (0.2) | 66 (0.3) | 1.09 |
| ACEis or ARBs | 12 398 (59.8) | 18 270 (60.2) | 13 249 (59.9) | 16 094 (62.3) | 5.10 |
| Anticoagulants | 1632 (7.9) | 2902 (9.6) | 2069 (9.4) | 2487 (9.6) | 6.20 |
| Procedures | |||||
| Coronary artery bypass | 1798 (8.7) | 3200 (10.5) | 1753 (7.9) | 2651 (10.3) | 5.43 |
| Percutaneous coronary intervention | 9385 (45.3) | 14 414 (47.5) | 10 481 (47.4) | 12 544 (48.6) | 6.60 |
| Cardiac catheterization | 14 982 (72.3) | 22 970 (75.7) | 16 404 (74.2) | 19 756 (76.5) | 9.67 |
| Organ failure | |||||
| Respiratory | 2205 (10.6) | 3228 (10.6) | 2195 (9.9) | 2750 (10.6) | 0.03 |
| Cardiac | 2812 (13.6) | 4223 (13.9) | 2793 (12.6) | 3416 (13.2) | 1.00 |
| Acute renal | 3540 (17.1) | 5308 (17.5) | 3840 (17.4) | 4457 (17.3) | 0.47 |
| Neurological | 1085 (5.2) | 1576 (5.2) | 1062 (4.8) | 1325 (5.1) | 0.47 |
| Hematological | 1143 (5.5) | 1914 (6.3) | 1267 (5.7) | 1446 (5.6) | 0.37 |
| Hepatic | 302 (1.5) | 470 (1.5) | 312 (1.4) | 417 (1.6) | 1.28 |
| Acidosis | 991 (4.8) | 1555 (5.1) | 1057 (4.8) | 1232 (4.8) | 0.05 |
Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; IQR, interquartile range; NA, not applicable.
a
Data are given as number (%) of patients unless otherwise specified.
b
Elixhauser comorbidities with greater than 5% prevalence.