Adjusted ORs (95% CIs) of clinical practices in patients with AHF
| Variables (%) | Study sample (administrative database) | |||
|---|---|---|---|---|
| Hospital subgroups by the number of cardiologists | ||||
| ≥10 | 5–9 | 1–4 | 0 | |
| n=6509 | n=15 337 | n=15 867 | n=955 | |
| In-hospital managements | ||||
| Non-pharmacological interventions | ||||
| Intubation | 1.43 (1.30 to 1.57) | 1.16 (1.07 to 1.25) | ref | 0.74 (0.56 to 0.97) |
| Right heart catheterisation | 1.84 (1.69 to 2.01) | 1.34 (1.25 to 1.45) | ref | 0.26 (0.17 to 0.40) |
| Percutaneous coronary intervention | 1.23 (1.06 to 1.43) | 1.02 (0.90 to 1.16) | ref | 0.14 (0.05 to 0.38) |
| Pacemaker | 1.47 (1.15 to 1.89) | 0.94 (0.76 to 1.17) | ref | 0.55 (0.24 to 1.24) |
| ICD | 5.19 (2.31 to 11.69) | 2.48 (1.10 to 5.57) | ref | – |
| CRT or CRT-D | 8.98 (5.81 to 13.89) | 4.08 (2.64 to 6.31) | ref | – |
| Coronary artery bypass grafting | 4.95 (2.28 to 10.79) | 1.98 (0.89 to 4.37) | ref | – |
| Intra-aortic balloon pump | 1.96 (1.36 to 2.82) | 1.57 (1.14 to 2.17) | ref | 0.33 (0.05 to 2.36) |
| Percutaneous cardiopulmonary support | 2.47 (1.41 to 4.31) | 1.62 (0.97 to 2.72) | ref | – |
| Intravenous drugs | ||||
| Diuretics | 0.87 (0.82 to 0.93) | 1.06 (1.01 to 1.12) | ref | 0.76 (0.66 to 0.88) |
| Carperitide | 2.02 (1.91 to 2.15) | 1.39 (1.33 to 1.45) | ref | 0.35 (0.29 to 0.41) |
| Heparin | 1.73 (1.63 to 1.84) | 1.44 (1.38 to 1.51) | ref | 0.45 (0.39 to 0.52) |
| ISDN or NTG | 1.41 (1.32 to 1.50) | 1.22 (1.16 to 1.28) | ref | 0.53 (0.44 to 0.63) |
| Nicorandil | 1.47 (1.30 to 1.67) | 1.20 (1.08 to 1.34) | ref | 0.20 (0.10 to 0.40) |
| Inotropes | ||||
| Dobutamine | 1.49 (1.36 to 1.63) | 1.48 (1.37 to 1.59) | ref | 0.69 (0.52 to 0.90) |
| Dopamine | 0.71 (0.65 to 0.78) | 1.08 (1.01 to 1.15) | ref | 0.79 (0.64 to 0.98) |
| Norepinephrine | 1.41 (1.25 to 1.59) | 1.24 (1.12 to 1.37) | ref | 1.09 (0.80 to 1.48) |
| Milrinone | 0.87 (0.72 to 1.06) | 0.91 (0.79 to 1.05) | ref | 0.36 (0.18 to 0.74) |
| Olprinone | 1.89 (1.43 to 2.50) | 0.82 (0.62 to 1.09) | ref | 0.50 (0.16 to 1.58) |
| Digoxin | 0.85 (0.75 to 0.95) | 1.06 (0.98 to 1.15) | ref | 1.01 (0.79 to 1.29) |
| Calcium channel blockers | 2.21 (1.96 to 2.49) | 1.39 (1.25 to 1.55) | ref | 0.68 (0.46 to 1.02) |
| Discharge medications | ||||
| Diuretics | 1.51 (1.37 to 1.66) | 1.14 (1.07 to 1.22) | ref | 0.63 (0.53 to 0.74) |
| ACEIs | 1.24 (1.16 to 1.33) | 1.00 (0.95 to 1.06) | ref | 0.44 (0.35 to 0.55) |
| ARBs | 1.16 (1.09 to 1.23) | 1.12 (1.06 to 1.17) | ref | 0.75 (0.65 to 0.87) |
| ACEI or ARBs | 1.35 (1.27 to 1.43) | 1.11 (1.06 to 1.16) | ref | 0.56 (0.48 to 0.64) |
| Aldosterone receptor blockers | 1.30 (1.23 to 1.38) | 1.15 (1.09 to 1.20) | ref | 0.64 (0.55 to 0.74) |
| Digitalis | 0.84 (0.77 to 0.92) | 1.03 (0.96 to 1.10) | ref | 1.23 (1.02 to 1.48) |
| β-blockers | 1.68 (1.58 to 1.78) | 1.26 (1.20 to 1.32) | ref | 0.49 (0.42 to 0.58) |
| Nitrates | 0.99 (0.91 to 1.07) | 0.97 (0.91 to 1.03) | ref | 1.37 (1.16 to 1.62) |
| Calcium channel blockers | 1.13 (1.05 to 1.21) | 1.14 (1.08 to 1.20) | ref | 0.93 (0.79 to 1.09) |
| Statins | 1.40 (1.31 to 1.50) | 1.23 (1.16 to 1.29) | ref | 0.52 (0.42 to 0.64) |
| Warfarin | 1.35 (1.27 to 1.44) | 1.16 (1.11 to 1.22) | ref | 0.70 (0.59 to 0.82) |
| Antiplatelets | 1.29 (1.22 to 1.38) | 1.12 (1.07 to 1.18) | ref | 0.59 (0.50 to 0.68) |
| Oral inotropic agents | 1.19 (1.06 to 1.34) | 1.13 (1.03 to 1.24) | ref | 0.61 (0.43 to 0.88) |
The ORs were adjusted for sex and age-group (<60, ≥60, ≥70, ≥80, and ≥90 years) using multivariable regression analyses.
ACEIs, ACE inhibitors; ARBs, angiotensin-receptor blockers; CRT-D, cardiac resynchronisation therapy defibrillator; ICD, implantable cardioverter-defibrillator; ISDN, isosorbide dinitrate; NTG, nitrogrycelin; ref, reference.