Racial and Ethnic Differences in 30-Day Readmission and 1-Year Mortality among Patients Hospitalized for Heart Failure

Abstract

Objective: Contemporary outcomes data among heart failure (HF) patients younger than age 65 are limited, especially among Hispanics. This study evaluated the association between race/ethnicity, 30-day readmission, and 1-year mortality among a diverse cohort of hospitalized HF patients overall and by age group. Methods: This was a 1-year prospective study of consecutively hospitalized patients with an admission diagnosis of HF who participated in a NHLBI clinical outcomes study (N=407; 52% white, 25% Hispanic, 20% black, 3% Asian; 38% female; mean age 65 ± 15 years). Demographics, comorbidities, medications, and outcomes (30-day readmssion; death at 1-year) were systematically obtained by clinical information system. Multivariate logistic regression was used to evaluate associations between race/ethnicity and outcomes, adjusted for covariates. Results: The 30-day readmission rate was 10% (n=41). By 1-year, 23% (n=94) of patients died. Hispanics had significantly higher odds of readmission versus whites/Asians (adjusted OR=3.1; 95% CI=1.4-6.9) and blacks (adjusted OR=3.6; 95%CI=1.2-10.3). These race/ethnic differences were observed among patients ≥ 65, but not <65 years old. In contrast, Hispanics had a lower 1-year death rate versus whites/Asians (16% versus 27%; p=0.03), not significant after covariate adjustment (adjusted OR=0.6; 95% CI=0.3-1.1), observed among patients ≥ 65 (OR=0.3; 95% CI=0.1-0.7), but not <65 years (OR=1.2; 95% CI=0.5-2.8). Conclusion: Among patients hospitalized for HF, older, but not younger, Hispanics had a higher 30-day readmission rate versus others. In contrast, 1-year death rate was lower among older, but not younger, Hispanics versus whites/Asians.