Rurality and event-free survival in patients with heart failure

Jia Rong Wu, Debra K. Moser, Mary Kay Rayens, Marla J. De Jong, Misook L. Chung, Barbara Riegel, Terry A. Lennie

Research output: Research - peer-reviewArticle

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.

LanguageEnglish (US)
JournalHeart and Lung: Journal of Acute and Critical Care
DOIs
StateAccepted/In press - May 28 2010

Fingerprint

Disease-Free Survival
Heart Failure
Urban Population
Medication Adherence
Marital Status
Rural Population
Survival Analysis
Social Support
Longitudinal Studies
Hospital Emergency Service
Demography
Depression
Health
Research
Protective Factors

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Wu, J. R., Moser, D. K., Rayens, M. K., De Jong, M. J., Chung, M. L., Riegel, B., & Lennie, T. A. (2010). Rurality and event-free survival in patients with heart failure. Heart and Lung: Journal of Acute and Critical Care. DOI: 10.1016/j.hrtlng.2009.11.002

Rurality and event-free survival in patients with heart failure. / Wu, Jia Rong; Moser, Debra K.; Rayens, Mary Kay; De Jong, Marla J.; Chung, Misook L.; Riegel, Barbara; Lennie, Terry A.

In: Heart and Lung: Journal of Acute and Critical Care, 28.05.2010.

Research output: Research - peer-reviewArticle

Wu JR, Moser DK, Rayens MK, De Jong MJ, Chung ML, Riegel B et al. Rurality and event-free survival in patients with heart failure. Heart and Lung: Journal of Acute and Critical Care. 2010 May 28. Available from, DOI: 10.1016/j.hrtlng.2009.11.002
Wu, Jia Rong ; Moser, Debra K. ; Rayens, Mary Kay ; De Jong, Marla J. ; Chung, Misook L. ; Riegel, Barbara ; Lennie, Terry A./ Rurality and event-free survival in patients with heart failure. In: Heart and Lung: Journal of Acute and Critical Care. 2010
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