Association between process indicators and in-hospital mortality among patients with chronic heart failure in China

Rong Fu, Jing Xiang, Han Bao, Zhiqiang Wang, Yupeng Wang, Yongjie Chen, Huimin Zhang, Dan Liu, Meina Liu

Research output: Contribution to journalArticle

Abstract

Background: Quality indicators for Chinese patients with chronic heart failure (CHF) have been developed. However, little is known about the compliance with quality indicators and the association between process indicators and in-hospital mortality in China. 

Methods: Data from 1862 CHF admissions between 1 January 2009 and 31 October 2010 at 20 tertiary hospitals in Heilongjiang Province were analyzed. Hierarchical generalized linear models were used to examine the association between six process indicators and in-hospital mortality in eligible patients. 

Results: The in-hospital mortality for the 1862 patients was 4.7%. The compliance with six process indicators were: evaluation of left ventricular function, 66.4%; angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), 54.9%; diuretic, 86.2%; beta-blocker, 45.1%; aldosterone-receptor antagonist, 64.0%; and warfarin, 17.1%. Rates of compliance at the hospital level varied from 0 to 100%. After the adjustment for confounding factors, evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist were significantly associated with in-hospital mortality ([OR, 0.55; 95% CI, 0.33–0.93; P = 0.027], [OR, 0.33; 95% CI, 0.12–0.94; P = 0.040] and [OR, 0.35; 95% CI, 0.13–0.98; P = 0.046], respectively). 

Conclusions: There are considerable gaps between guidelines and clinical practice and variations across hospitals for the treatment of patients with CHF. Evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist will reduce the risk of in-hospital mortality. The association of other process indicators with clinical outcomes remain to be established.
Original languageEnglish
Pages (from-to)373-378
Number of pages6
JournalEuropean Journal of Public Health
Volume25
Issue number3
DOIs
Publication statusPublished - Jun 2015
Externally publishedYes

Fingerprint Dive into the research topics of 'Association between process indicators and in-hospital mortality among patients with chronic heart failure in China'. Together they form a unique fingerprint.

Cite this