Abstract 207: High Blood Pressure Effects on the Outcomes of Cardiovascular Events: Teaching versus Non Teaching Hospitals

Abstract

Background: The effects of blood pressure on outcomes of inpatients with cardiovascular related diseases in teaching and non teaching hospitals are not well known. In this study we are investigating the prevalence of hypertension and other co-morbidities on the length of stay and transfers of inpatients’ with heart attack in teaching and non teaching hospitals. Method: Patients were selected using International Classification of Diseases-9-Clinical Modification primary diagnosis codes from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database. Data were retrospectively extracted from 1,056 hospitals in 42 States with 8,158,381 samples in 2008. Multivariate statistical techniques were used to examine patient characteristics and outcomes of inpatient with heart attack, diabetes and other co-morbidities in teaching and non teaching hospitals. Results: The percentage of hospital length of stay for a day or less than one day was higher in non- teaching than in teaching hospitals for patients’ co-morbidities. Especially for hypertension, the percentage was higher in non-teaching hospitals, X 2 = 25.236, df = 6, p =.000. The percentage of longer lengths of stay (7-13 days) for congestive heart failure (CHF) was also higher in non teaching hospitals (34.9%) than teaching hospitals (25%). The results correlate with the symptomatic effects of heart attack. High blood pressure resulting into rupture, clot and necrotic tissues which limits blood circulation, hence heart attack. In addition, inpatients’ with chronic pulmonary disease (X 2 = 37.225, df = 4, p =.000) and hypertension (X 2 = 46.058, df = 4, p =.000) had higher transfer rates in non-teaching hospitals. The difference between teaching and non-teaching hospitals was statistically significant for chronic pulmonary disease and hypertension was large enough to affect clinical policy. Conclusions: This study has ascertained that the effect of hypertension on the length of stay and transfers of inpatients with cardiovascular events in teaching and non teaching hospitals is highly significant. Hence, it is suggested that there should be a policy in place to screen all patients for hypertension and other co-morbidities on admission to prevent cardiovascular complications.