African Americans are less likely to receive care by a cardiologist during an intensive care unit admission for heart failure
JACC: Heart Failure, 2018•jacc.org
Objectives: This study sought to determine whether the likelihood of receiving primary
intensive care unit (ICU) care by a cardiologist versus a noncardiologist was greater for
Caucasians than for African Americans admitted to an ICU for heart failure (HF). The authors
further evaluated whether primary ICU care by a cardiologist is associated with higher in-
hospital survival, irrespective of race. Background: Increasing data demonstrate an
association between better HF outcomes and care by a cardiologist. It is unclear if previously …
intensive care unit (ICU) care by a cardiologist versus a noncardiologist was greater for
Caucasians than for African Americans admitted to an ICU for heart failure (HF). The authors
further evaluated whether primary ICU care by a cardiologist is associated with higher in-
hospital survival, irrespective of race. Background: Increasing data demonstrate an
association between better HF outcomes and care by a cardiologist. It is unclear if previously …
Objectives
This study sought to determine whether the likelihood of receiving primary intensive care unit (ICU) care by a cardiologist versus a noncardiologist was greater for Caucasians than for African Americans admitted to an ICU for heart failure (HF). The authors further evaluated whether primary ICU care by a cardiologist is associated with higher in-hospital survival, irrespective of race.
Background
Increasing data demonstrate an association between better HF outcomes and care by a cardiologist. It is unclear if previously noted racial differences in cardiology care persist in an ICU setting.
Methods
Using the Premier database, adult patients admitted to an ICU with a primary discharge diagnosis of HF from 2010 to 2014 were included. Hierarchical logistic regression models were used to determine the association between race and primary ICU care by a cardiologist, adjusting for patient and hospital variables. Cox regression with inverse probability weighting was used to assess the association between cardiology care and in-hospital mortality.
Results
Among 104,835 patients (80.3% Caucasians, 19.7% African Americans), Caucasians had higher odds of care by a cardiologist than African Americans (adjusted odds ratio: 1.42; 95% confidence interval: 1.34 to 1.51). Compared with a noncardiologist, primary ICU care by a cardiologist was associated with higher in-hospital survival (adjusted hazard ratio: 1.20, 95% confidence interval: 1.11 to 1.28). The higher likelihood of survival did not differ by patient race (interaction p = 0.32).
Conclusions
Among patients admitted to an ICU for HF, African Americans were less likely than Caucasians to receive primary care by a cardiologist. Primary care by a cardiologist was associated with higher survival for both Caucasians and African Americans.
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