Rurality and Event-free Survival in Patients with Heart Failure

Overview

Journal Heart Lung

Specialty Cardiology & Vascular Diseases

Date 2010 Jun 22

PMID 20561853

Citations 8

Authors

Jia-Rong Wu

Debra K Moser

Mary Kay Rayens

Marla J De Jong

Misook L Chung

Barbara Riegel

Terry A Lennie

Affiliations

Soon will be listed here.

Abstract

Background: Evidence of health disparities between urban and rural populations usually favors urban dwellers. The impact of rurality on heart failure (HF) outcomes is unknown.

Objective: We compared event-free survival between HF patients living in urban and rural areas.

Methods: In this longitudinal study, 136 patients with HF (male, 70%; age, mean ± SD 61 ± 11 years; New York Heart Association class III/IV, 60%) were enrolled. Patients' emergency department visits for HF exacerbation and rehospitalization during follow-up were identified. Rural status was determined by rural-urban commuting area code. Survival analysis was used to determine the effect of rurality on outcomes while controlling for relevant demographic, clinical, and psychosocial variables.

Results: Rural patients (64%) had longer event-free survival than urban patients (P = .015). Rurality (P = .04) predicted event-free survival after controlling for age, marital status, New York Heart Association class, medications, adherence to medications, depressive symptoms, and social support.

Conclusions: Rural patients were less likely than their urban counterparts to experience an event. Further research is needed to identify protective factors that may be unique to rural settings.

Citing Articles

Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review.

Enard K, Coleman A, Yakubu R, Butcher B, Tao D, Hauptman P J Am Heart Assoc. 2023; 12(3):e026590.

PMID: 36695317 PMC: 9973629. DOI: 10.1161/JAHA.122.026590.

The Role of Depression on Treatment Adherence in Patients with Heart Failure-a Systematic Review of the Literature.

Poletti V, Pagnini F, Banfi P, Volpato E Curr Cardiol Rep. 2022; 24(12):1995-2008.

PMID: 36327056 PMC: 9747824. DOI: 10.1007/s11886-022-01815-0.

Rurality, Death, and Healthcare Utilization in Heart Failure in the Community.

Manemann S, St Sauver J, Henning-Smith C, Finney Rutten L, Chamberlain A, Fabbri M J Am Heart Assoc. 2021; 10(4):e018026.

PMID: 33533260 PMC: 7955348. DOI: 10.1161/JAHA.120.018026.

Adverse-Event Free Survival, Hospitalizations, and Mortality in Left Ventricular Assist Device Recipients: A Rural-Urban Cohort Comparison.

Alonso W, Hupcey J, Kitko L, Pozehl B, Kupzyk K J Cardiovasc Nurs. 2019; 34(6):454-464.

PMID: 31365445 PMC: 8381739. DOI: 10.1097/JCN.0000000000000597.

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure.

Lennie T, Andreae C, Rayens M, Song E, Dunbar S, Pressler S J Am Heart Assoc. 2018; 7(17):e007251.

PMID: 30371170 PMC: 6201427. DOI: 10.1161/JAHA.117.007251.

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