African Americans Are Less Likely to Receive Care by a Cardiologist During an Intensive Care Unit Admission for Heart Failure.
Liu, Wenhui G
Allen, Larry A
Daugherty, Stacie L
Blair, Irene V
Grunwald, Gary K
Kiser, Tyree H
Vandivier, R William
Clark, Brendan J
Lewis, Eldrin F
Ho, P Michael
Peterson, Pamela N
AffiliationUniv Arizona, Sarver Heart Ctr, Div Cardiovasc Med
MetadataShow full item record
PublisherELSEVIER SCI LTD
CitationBreathett, K., Liu, W. G., Allen, L. A., Daugherty, S. L., Blair, I. V., Jones, J., ... & Vandivier, R. W. (2018). African Americans Are Less Likely to Receive Care by a Cardiologist During an Intensive Care Unit Admission for Heart Failure. JACC: Heart Failure, 6(5), 413-420, https://doi.org/10.1016/j.jchf.2018.02.015
Rights© 2018 by the American College of Cardiology Foundation. Published by Elsevier.
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AbstractThis study sought to determine whether the likelihood of receiving primary intensive care unit (ICU) care by a cardiologist versus a noncardiologist was greater for Caucasians than for African Americans admitted to an ICU for heart failure (HF). The authors further evaluated whether primary ICU care by a cardiologist is associated with higher in-hospital survival, irrespective of race. Increasing data demonstrate an association between better HF outcomes and care by a cardiologist. It is unclear if previously noted racial differences in cardiology care persist in an ICU setting. Using the Premier database, adult patients admitted to an ICU with a primary discharge diagnosis of HF from 2010 to 2014 were included. Hierarchical logistic regression models were used to determine the association between race and primary ICU care by a cardiologist, adjusting for patient and hospital variables. Cox regression with inverse probability weighting was used to assess the association between cardiology care and in-hospital mortality. Among 104,835 patients (80.3% Caucasians, 19.7% African Americans), Caucasians had higher odds of care by a cardiologist than African Americans (adjusted odds ratio: 1.42; 95% confidence interval: 1.34 to 1.51). Compared with a noncardiologist, primary ICU care by a cardiologist was associated with higher in-hospital survival (adjusted hazard ratio: 1.20, 95% confidence interval: 1.11 to 1.28). The higher likelihood of survival did not differ by patient race (interaction p = 0.32).
Note12 month embargo; published online: 30 April 2018
VersionFinal accepted manuscript
SponsorsAmerican Heart Association (AHA) Strategically Focused Research Network [16SFRN29640000]; National Institutes of Health (NIH) [L60 MD010857]; NIH/NCATS Colorado Clinical and Translational Sciences Institute [ULI TR001082]; University of Colorado, Department of Medicine, Health Services Research Development Grant Award; University of Arizona Health Sciences, Strategic Priorities Faculty Initiative Grant; NIH [K23 HL105896, K23 AA021814]; Patient Centered Outcomes Research Institute [CDR-1310-06998]; AHA [16SFRN29640000, 2515963, 15SFDRN24180024]; National Heart, Lung, and Blood Institute (NHLBI) [K08 HL103776, RO1 HL133343]; NHLBI [RO1 HL133343]; Flight Attendant Medical Research Institute [CIA092054, 150001F]; AHA
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