Table 1.
Characteristics of REGARDS Participants Hospitalized for HF by Readmission Status.
| Characteristics | Total (N=690) | No 30-day Readmission (n=535) | 30-day Readmission (n=155) | p-value |
|---|---|---|---|---|
| SDOH | ||||
| Black Race | 245 (35.5%) | 185 (34.6%) | 60 (38.7%) | 0.34 |
| Low Educational Attainment | 162 (23.5%) | 124 (23.2%) | 38 (24.5%) | 0.73 |
| Low Income | 377 (63.0%) | 295 (63.3%) | 82 (62.1%) | 0.8 |
| Zip code level poverty | 143 (21.0%) | 109 (20.6%) | 34 (22.4%) | 0.64 |
| Health Professional Shortage Area | 300 (43.5%) | 219 (40.9%) | 81 (52.3%) | 0.01 |
| Poor Public Health Infrastructure | 271 (39.3%) | 213 (39.8%) | 58 (37.4%) | 0.59 |
| Social Isolation | 88 (13.1%) | 64 (12.3%) | 24 (15.8%) | 0.26 |
| Social Network | 85 (13.3%) | 67 (13.5%) | 18 (12.6%) | 0.78 |
| Rural residence | 64 (10.2%) | 47 (9.7%) | 17 (12.0%) | 0.43 |
| Demographics | ||||
| Age at hospitalization, median (IQR) | 76.0 (71.0, 82.0) | 76.0 (72.0, 82.0) | 75.0 (70.0, 81.0) | 0.10 |
| Female | 306 (44.3%) | 244 (45.6%) | 62 (40.0%) | 0.22 |
| Region of residence | 0.50 | |||
| Belt | 250 (36.2%) | 193 (36.1%) | 57 (36.8%) | |
| Buckle | 152 (22.0%) | 123 (23.0%) | 29 (18.7%) | |
| Non-belt | 288 (41.7%) | 219 (40.9%) | 69 (44.5%) | |
| Health Behaviors and Medical Conditions | ||||
| Current Smoking | 66 (9.6%) | 43 (8.0%) | 23 (14.8%) | 0.01 |
| Charlson Comorbidity Index, median (IQR) | 4.0 (3.0, 5.0) | 3.5 (2.5, 5.0) | 4.0 (3.0, 5.0) | 0.09 |
| Physical and Mental Functioning | ||||
| Impaired Cognition* | 113 (17.8%) | 82 (16.5%) | 31 (22.8%) | 0.09 |
| PCS- Physical Health†, median (IQR) | 41.7 (31.6, 49.9) | 41.8 (31.4, 50.4) | 41.3 (32.3, 49.2) | 0.63 |
| MCS-Mental Health†, median (IQR) | 56.7 (49.5, 59.9) | 56.7 (49.6, 59.9) | 56.0 (48.3, 60.2) | 0.85 |
| Hospital Characteristics and Transitions to Care | ||||
| ICU stay during hospitalization | 145 (21.0%) | 109 (20.4%) | 36 (23.2%) | 0.44 |
| MI during hospitalization | 111 (16.1%) | 80 (15.0%) | 31 (20.0%) | 0.13 |
| Revascularization during hospitalization | 79 (11.4%) | 57 (10.7%) | 22 (14.2%) | 0.22 |
| Consult with cardiologist | 211 (30.6%) | 171 (32.0%) | 40 (25.8%) | 0.14 |
| Discharged to nursing home | 85 (12.5%) | 59 (11.2%) | 26 (17.0%) | 0.05 |
| Length of stay, median (IQR) | 5.0 (3.0, 8.0) | 5.0 (3.0, 7.0) | 6.0 (4.0, 9.0) | 0.01 |
| Ejection Fraction < 50‡, | 280 (55.0%) | 218 (54.1%) | 62 (58.5%) | 0.42 |
| Hospital Characteristics | ||||
| Bed size||, median (IQR) | 348.5 (201.0, 564.0) | 363.5 (213.0, 580.0) | 328.0 (180.0, 509.0) | 0.08 |
| Teaching status# | 324 (47.1%) | 254 (47.6%) | 70 (45.5%) | 0.64 |
| Hospital Quality Rating**, mean (SD) | 2.9 (0.9) | 2.9 (0.9) | 2.8 (0.9) | 0.42 |
Data were collected from four sources: the REGARDS baseline assessment; medical charts from each HF-adjudicated hospitalization; the American Hospital Association annual survey database; and Medicare’s Hospital Compare website. Region of residence: Stroke Buckle (coastal North and South Carolina and Georgia), Stroke Belt (the remainder of North and South Carolina and Georgia, and Alabama, Mississippi, Louisiana, Arkansas, and Tennessee), and Non-Belt.
Cognitive impairment was defined as a Six-item Screener score of <5. Note, the SIS performed prior to and as close to the adjudicated HF hospitalization was used.
Physical and mental health were assessed with the Short-Form (SF-12) which comprises of the Physical Component Summary (PCS) and Mental Component Summary (MCS). MCS and PCS scores range from 0 to 100 with higher scores representing better health.
Heart failure was classified as preserved ejection fraction (HFpEF) for those with left ventricular ejection fraction (LVEF) > 50% or a qualitative description of normal systolic function; and heart failure with ejection fraction (HFrEF) for those with a LVEF < 50% or a qualitative description of abnormal systolic function. We grouped individuals with LVEF between 40 and 50% with individuals with HFrEF.
Small hospital size was defined as <200 beds.
Teaching status was defined as the academic status of the hospital.
Hospital quality was determined using the Medicare’s Hospital Compare website which lists publicly available information regarding the quality of care of over 4,000 Medicare-certified hospitals. Hospital ratings are scored within a range of 1–5, with 3 being average and higher scores reflecting higher quality care.
Largest sources of missing data: Income (n=92), zip code level poverty (n=9), social isolation (n=17), social network (n=50), rural residence (n=62), Charlson (n=30, cog impairment (n=56), pcs (n=47), mcs (n=47), discharged to nursing home (n=10), bed size (n=2), and hospital quality rating (n=38).