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HOSPITAL TEACHING STATUS AND IN-HOSPITAL MORTALITY AFTER ACUTE RESPIRATORY FAILURE

Jersey Shore University Medical Center, Neptune, NJ

PURPOSE: Acute respiratory failure (ARF) associates with high likelihood of death. However, whether admitting to a teaching hospital (TH) has a better outcome on in-hospital mortality after acute respiratory failure is of interest.

METHODS: : Adult ARF patients ( 18 years) from the US Nationwide Inpatient Sample database were reviewed. A TH is an institute which meets atleast one of of the following criteria: 1) Residency training approval by the Accreditation Council for Graduate Medical Education, 2) Membership in the Council of Teaching Hospitals, 3) A ratio of full-time equivalent interns and residents to beds of 25 or higher. In-hospital mortality is the primary outcome. Multiple logistic regression models were used to assess the association between hospital teaching status and in-hospital mortality.

RESULTS: There were 82,121 emergency admissions for ARF in 2003–2006. Admission to the teaching hospitals were 40.3%. Patients who admitted to TH were younger (mean[standard deviation]: 66.2[16.1] vs. 67.6[15.1] years, P<0.0001), different in race distribution (P<0.0001), but similar in gender distribution. The overall mortality was 24.3%. TH had a significant higher mortality rate (25.4% vs. 23.6%, P<0.0001). From a multiple logistic regression model, patients admitted to TH had a higher chance of mortality (odds ratio: 1.12, 95% confidence interval: [1.08, 1.16], P<0.0001), while controlling for gender, race, insurance, admission source, median household income, bed size and region of hospital and major comorbidities.

CONCLUSION: This study found an increased mortality associated with admissions to a teaching hospital after acute respiratory failure. Further studies are necessary to explore the potential factors for causing this association.

CLINICAL IMPLICATIONS: It seems to be a higher mortality in teaching hospital in patients with acute respiratory failure. further studies are required to identify the factor associated with.

DISCLOSURE: Yen-Hong Kuo, No Financial Disclosure Information; No Product/Research Disclosure Information