Use of echocardiography and heart failure mortality from registry data in Japan
Abstract Background There are several recommendations for the use of echocardiography in acute hospitalized HF. Echocardiography requires a high degree of skill on the part of the examiner, and the skill may be more improved in larger volume centers. Purpose In this study, we investigated whether th...
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| Published in: | European heart journal Vol. 42; no. Supplement_1 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
12-10-2021
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| Online Access: | Get full text |
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| Summary: | Abstract
Background
There are several recommendations for the use of echocardiography in acute hospitalized HF. Echocardiography requires a high degree of skill on the part of the examiner, and the skill may be more improved in larger volume centers.
Purpose
In this study, we investigated whether the use and volume of echocardiography is associated with in-hospital mortality from the real world registry database of heart failure (HF) hospitalizations.
Methods
This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). We categorized the 739 hospitals into 3 groups according to the number of echocardiographic studies performed annually (first tertile: <2500 cases, second tertile: 2500–4500 cases, third tertile: >4500 cases) and compared the groups of patients who were first admitted to the categorized hospitals with heart failure between April 2015 and March 2016. We estimated the odds ratios and their 95% confidence interval for in-hospital mortality using multivariable models. The variables of multivariable analysis were selected by stepwise method.
Results
A total of 80,496 HF patients were hospitalized, and 73.2% were examined for echocardiography. We found that the use and volume of echocardiography exams were associated with significantly lower odds of all-cause hospital mortality in heart failure (adjusted OR: 0.48 for use of echocardiography and 0.78 for the third tertile; both P<0.001).
Conclusions
The use of echocardiography was associated with decreased odds of hospital mortality in HF. The volumes of echocardiographic examinations were also associated with hospital mortality; thus, this study suggests that the skill of echocardiography may be improved in the large volume center and provide good outcomes in HF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science (JSPS) Flowchart of this studyOdds ratio of in-hospital mortality |
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| ISSN: | 0195-668X 1522-9645 |
| DOI: | 10.1093/eurheartj/ehab724.1026 |