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Table 1 Differences in Demographic, Clinical, and Facility Characteristics among Kidney Transplant Patients Admitted with Cardiovascular Disease, by Transplant Hospital Status

From: Factors associated with adverse outcomes from cardiovascular events in the kidney transplant population: an analysis of national discharge data, hospital characteristics, and process measures

Demographic and Clinical Characteristics

 

Non-transplant Hospital (n = 197)

Transplant Hospital (n = 78)

Total

(n = 275)

p-value

Hospitalizations (n,%)

3893, 49.9%

3910, 50.1%

  

Year of admission

   

< 0.001

 2009

1182 (30.4%)

1349 (34.5%)

2531 (32.4%)

 

 2010

1238 (31.8%)

1155 (29.5%)

2393 (30.7%)

 

 2011

1473 (37.8%)

1406 (36.0%)

2879 (36.9%)

 

Age, Median (Q1, Q3)

64 (55.0, 70.0)

62 (53.0, 69.0)

63 (54.0, 70.0)

< 0.001

Female

1484 (38.1%)

1453 (37.2%)

2937 (37.6%)

0.37

Race, White

2337 (64.4%)

2109 (57.4%)

4446 (60.9%)

< 0.001

Cardiovascular Diagnosis

 MI (410.x)

383 (9.8%)

305 (7.8%)

688 (8.8%)

0.002

 Stroke (997.x/436/437.1)

247 (6.3%)

461 (11.8%)

708 (9.1%)

< 0.001

 CHF (428.x)

2110 (54.2%)

1968 (50.3%)

4078 (52.3%)

< 0.001

 Dysrhythmia (427.x)

2138 (54.9%)

2027 (51.8%)

4165 (53.4%)

0.006

 Cardiac arrest (427.5/997.1)

85 (2.2%)

102 (2.6%)

187 (2.4%)

0.22

 Malignant HTN (402.x)

59 (1.5%)

85 (2.2%)

144 (1.8%)

0.03

Number of CV diagnosis

   

0.02

 1

2902 (74.5%)

3005 (76.9%)

5907 (75.7%)

 

 ≥ 2

991 (25.5%)

905 (23.1%)

1896 (24.3%)

 

Weighted Charlson score

   

< 0.001

 0

467 (12.0%)

828 (21.2%)

1295 (16.6%)

 

 1

471 (12.1%)

754 (19.3%)

1225 (15.7%)

 

 2

1158 (29.7%)

1102 (28.2%)

2260 (29.0%)

 

 3+

1797 (46.2%)

1226 (31.4%)

3023 (38.7%)

 

Diabetes mellitus

2012 (51.7%)

1959 (50.1%)

3971 (50.9%)

0.16

Dialysis use in hospital

749 (19.2%)

356 (9.1%)

1105 (14.2%)

< 0.001

Admission type

   

< 0.001

 Emergent/Urgent

2884 (88.3%)

2850 (83.1%)

5734 (85.6%)

 

 Elective/Others

383 (11.7%)

581 (16.9%)

964 (14.4%)

 

 Transferred in indicator

302 (7.8%)

509 (13.0%)

811 (10.4%)

< 0.001

Cardiovascular Procedure (catheter-based or cardiac surgery)

757 (19.5%)

772 (19.7%)

1529 (19.6%)

0.74

Died in hospital

146 (3.8%)

117 (3.0%)

263 (3.4%)

0.06

Facility Structural Characteristics

Hospital Type

   

0.09

 Government, nonfederal

14 (7.1%)

12 (15.4%)

26 (9.5%)

 

 Non-profit, non-gov’t

175 (88.8%)

62 (79.5%)

237 (86.2%)

 

 Investor-owned

8 (4.1%)

4 (5.1%)

12 (4.4%)

 

 Medical/surgical intensive care

191 (97.0%)

78 (100.0%)

269 (97.8%)

0.12

 Cardiac intensive care

141 (71.6%)

71 (91.0%)

212 (77.1%)

< 0.001

 HMO hospital

17 (8.6%)

9 (11.5%)

26 (9.5%)

0.46

 PPO hospital

16 (8.1%)

3 (3.8%)

19 (6.9%)

0.21

 Specialty cardiology & cardiac surgery services

186 (94.4%)

77 (98.7%)

263 (95.6%)

0.12

 Freestanding/Satellite ED hospital

25 (12.7%)

6 (7.7%)

31 (11.3%)

0.24

 Multi-detector 64-slice spiral CT

171 (86.8%)

75 (96.2%)

246 (89.5%)

0.02

 Radiology interventional therapy

131 (66.5%)

73 (93.6%)

204 (74.2%)

< 0.001

Hospital unit inpatient days

   

< 0.001

 First quartile

62 (31.5%)

6 (7.7%)

68 (24.7%)

 

 Second quartile

58 (29.4%)

11 (14.1%)

69 (25.1%)

 

 Third quartile

51 (25.9%)

18 (23.1%)

69 (25.1%)

 

 Fourth quartile

26 (13.2%)

43 (55.1%)

69 (25.1%)

 

Proportion of hospital unit Medicare discharges

   

< 0.001

 Median (Q1, Q3)

0.5 (0.4, 0.5)

0.4 (0.3, 0.4)

0.4 (0.4, 0.5)

 

Proportion of hospital unit Medicaid discharges

   

< 0.001

 Median (Q1, Q3)

0.1 (0.1, 0.2)

0.2 (0.2, 0.3)

0.2 (0.1, 0.2)

 

Number of Operating Rooms

   

< 0.001

 Median (Q1, Q3)

14 (10.0, 18.0)

26 (19.0, 37.0)

16 (11.0, 24.0)

 

Total surgical operations

   

< 0.001

 Median (Q1, Q3)

10,927

20,764

12,152

 

(8018, 15,101)

(11,209, 27,502)

(8504, 19,382)

Surgical intensity (Surgical procedures/inpatient beds/year)

   

0.31

 Median (Q1, Q3)

35.3

37.8

36.5

 

(26.6, 46.5)

(30.1, 48.4)

(27.6, 47.1)

Hospital total expenses

   

< 0.001

 First quartile

62 (31.5%)

6 (7.7%)

68 (24.7%)

 

 Second quartile

60 (30.5%)

9 (11.5%)

69 (25.1%)

 

 Third quartile

58 (29.4%)

11 (14.1%)

69 (25.1%)

 

 Fourth quartile

17 (8.6%)

52 (66.7%)

69 (25.1%)

 

Physician FTEs/10 beds

   

0.62

 Median

0.3

0.3

0.3

 

 Q1, Q3

0, 1.1

0, 1.7

0, 1.2

 

 Range

(0–23.5)

(0–24.6)

(0–24.6)

 

Teaching Status

   

< 0.001

 Nonteaching

90 (54.2%)

18 (24.7%)

108 (45.2%)

 

 Minor teaching

61 (36.8%)

15 (20.5%)

76 (20.6%)

 

 Major teaching

15 (9.0%)

40 (54.8%)

55 (54.8%)

 

FTEs nurses/10 beds

   

< 0.001

 Median

16.8

22.2

17.6

 

 Q1, Q3

13.8, 19.9

17.4, 26.9

14.3, 22.3

 

 Range

(0.2–47.3)

(0.2–41.6)

(0.2–47.3)

 

Hospital Process Factors – Timely & Effective Care: Heart Attack

 Fibrinolytic therapy received within 30 min of ED arrival (percentage)

N = 58

N = 24

N = 82

0.88

  Median

50

41.5

50

 

  Q1, Q3

0, 100

0, 100

0, 100

 

 Aspirin at arrival (percentage)

N = 194

N = 77

N = 271

0.18

  Median

100

100

100

 

  Q1, Q3

99, 100

99, 100

99, 100

 

 Time to transfer to another facility for acute coronary intervention (minutes)

N = 37

N = 7

N = 44

0.08

  Median

78

42

73.5

 

  Q1, Q3

57, 105

30, 121

51, 106.5

 

 Time to ECG (minutes)

N = 161

N = 51

N = 212

0.01

  Median

11

16

12

 

  Q1, Q3

8, 18

8, 26

8, 19

 

Hospital Mortality and Unplanned Hospital Visits

 Acute myocardial infarction 30-day mortality rate (percentage)

N = 183

N = 75

N = 258

0.31

  Median

16.1

15.9

16

 

  Q1, Q3

15.1, 17.1

14.6, 17.4

14.9, 17.1

 

 Heart failure 30-day mortality rate (percentage)

N = 186

N = 76

N = 262

0.10

  Median

10.9

10.7

10.8

 

  Q1, Q3

10, 12

9.8, 11.8

10, 12

 

 Acute myocardial infarction 30-day readmission rate (percentage)

N = 183

N = 76

N = 259

0.13

  Median

20.1

20.5

20.2

 

  Q1, Q3

19.2, 21.4

19.7, 21.5

19.3, 21.4

 

 Heart failure 30-day readmission rate (percentage)

N = 186

N = 76

N = 262

0.83

  Median

24.7

25.0

24.8

 

  Q1, Q3

23.4, 26.6

23.4, 26.8

23.4, 26.7