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dc.contributor.authorGrazette, L.
dc.contributor.authorTran, J.S.
dc.contributor.authorZawadzki, N.K.
dc.contributor.authorZawadzki, R.S.
dc.contributor.authorMcLeod, J.M.
dc.contributor.authorFong, M.W.
dc.contributor.authorWilson, M.L.
dc.contributor.authorHavakuk, O.
dc.contributor.authorHay, J.W.
dc.date.accessioned2022-03-18T00:03:44Z
dc.date.available2022-03-18T00:03:44Z
dc.date.issued2022
dc.identifier.citationGrazette, L., Tran, J. S., Zawadzki, N. K., Zawadzki, R. S., McLeod, J. M., Fong, M. W., Wilson, M. L., Havakuk, O., & Hay, J. W. (2022). Geographic variation in the use of continuous outpatient inotrope infusion therapy and beta blockers. IJC Heart and Vasculature.
dc.identifier.issn2352-9067
dc.identifier.doi10.1016/j.ijcha.2021.100948
dc.identifier.urihttp://hdl.handle.net/10150/663647
dc.description.abstractBackground: Continuous outpatient inotrope infusion therapy (COIIT) can be used as palliative or interim treatment in patients with advanced heart failure (AHF). Despite widespread use, there is a relative lack of data informing best practices. This study aimed to examine whether patterns of COIIT use differed by region and to explore whether observed differences influenced clinical outcomes. Methods: Retrospective study of AHF patients receiving COIIT from May 2009 through June 2016. The primary outcome was regional difference, the secondary outcome was persistence (duration) on therapy. Cox proportional hazards model was used to calculate hazard ratios for treatment regimens. Results: There were 3,286 patients, mean (SD) age 61.9 (14.4) years and 74.0% (2,433) male. Inotrope selection and beta blocker use varied by region by chi square (χ2 (21) = 166.9, p < 0.001). Persistence was greater on milrinone compared to dobutamine (HR (for discontinuation) 0.54, CI 0.41–0.70, p < 0.001). Concurrent beta-blocker was associated with greater persistence for patients receiving milrinone (HR 0.13, CI 0.08–0.20, p < 0.001) and dobutamine (HR 0.36, CI 0.18–0.71, p < 0.001). Conclusions: Patterns of COIIT use varied by region, and variations in use were associated with differences in clinical outcomes. © 2021
dc.language.isoen
dc.publisherElsevier Ireland Ltd
dc.rightsCopyright © 2021 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAdvanced heart failure
dc.subjectInotrope
dc.subjectOutpatient infusion
dc.subjectPalliation
dc.subjectQuality of life
dc.titleGeographic variation in the use of continuous outpatient inotrope infusion therapy and beta blockers
dc.typeArticle
dc.typetext
dc.contributor.departmentSarver Heart Center, University of Arizona
dc.identifier.journalIJC Heart and Vasculature
dc.description.noteOpen access journal
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
dc.eprint.versionFinal published version
dc.source.journaltitleIJC Heart and Vasculature
refterms.dateFOA2022-03-18T00:03:44Z


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Copyright © 2021 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Except where otherwise noted, this item's license is described as Copyright © 2021 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).