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中东裔与密歇根东南部非中东裔白人心衰患者的死亡率和再入院率比较。

Mortality and Hospital Readmission Rates for Heart Failure Among Patients of Middle Eastern Ancestry Compared to Non-Middle Eastern Whites in Southeast Michigan.

机构信息

Department of Family Medicine, Oakland University William Beaumont School of Medicine and Beaumont Health Family Medicine Residency, 44250 Dequindre Rd, Sterling Heights, Troy, MI, 48314, USA.

出版信息

J Immigr Minor Health. 2023 Aug;25(4):835-840. doi: 10.1007/s10903-023-01473-6. Epub 2023 Apr 8.

Abstract

Outcomes after hospital admission for heart failure are likely affected by cultural and ethnic factors. We obtained data from a large health system in Southeast Michigan on all patients admitted for heart failure from 2008 to 2015. Middle Eastern patients were identified through self-identification and a surname algorithm. Multivariate linear, logistic, and Cox regression models were used to evaluate length of stay and readmission rates compared to Caucasian patients. Mortality data was collected from the National Death Index. 7,784 white and 642 Middle Eastern patients were identified. Middle Eastern patients were younger, had higher rates of comorbid conditions, and had a greater mean hospital length of stay (7.96 vs 7.03 days, p = 0.015). Middle Eastern patients had similar thirty-day hospital readmission risk (4.25% vs 4.47%, p = 0.370) but greater ninety-day readmission risk (9.01% vs 8.35%, p = 0.043); after controlling for covariates these differences were not significant. Middle Eastern patients had lower mortality risk (HR = 0.79, p = 0.003). After a hospital admission for heart failure, Middle Eastern patients had longer hospital lengths of stay, similar risk of hospital readmission, but lower all-cause mortality.

摘要

住院治疗心力衰竭的结果可能受到文化和种族因素的影响。我们从密歇根州东南部的一个大型医疗系统中获取了 2008 年至 2015 年所有因心力衰竭住院的患者的数据。中东患者通过自我认同和姓氏算法确定。使用多元线性、逻辑和 Cox 回归模型来评估与白人患者相比的住院时间和再入院率。死亡率数据来自国家死亡指数。共确定了 7784 名白人患者和 642 名中东患者。中东患者更年轻,合并症发生率更高,平均住院时间更长(7.96 天 vs. 7.03 天,p=0.015)。中东患者 30 天内再入院风险相似(4.25% vs. 4.47%,p=0.370),但 90 天内再入院风险更高(9.01% vs. 8.35%,p=0.043);在控制了混杂因素后,这些差异没有统计学意义。中东患者的死亡率较低(HR=0.79,p=0.003)。因心力衰竭住院后,中东患者的住院时间更长,住院再入院风险相似,但全因死亡率较低。

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