Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure
<i>Background</i>: Among the clinical predictors of a heart failure (HF) prognosis, different personal factors have been established in previous research, mainly age, gender, anemia, renal insufficiency and diabetes, as well as mediators (pulmonary embolism, hypertension, chronic obstruc...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/6/995 |
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| author | Juan Manuel García-Torrecillas María Carmen Lea-Pereira Enrique Alonso-Morillejo Emilio Moreno-Millán Jesús de la Fuente-Arias |
| author_facet | Juan Manuel García-Torrecillas María Carmen Lea-Pereira Enrique Alonso-Morillejo Emilio Moreno-Millán Jesús de la Fuente-Arias |
| author_sort | Juan Manuel García-Torrecillas |
| collection | DOAJ |
| description | <i>Background</i>: Among the clinical predictors of a heart failure (HF) prognosis, different personal factors have been established in previous research, mainly age, gender, anemia, renal insufficiency and diabetes, as well as mediators (pulmonary embolism, hypertension, chronic obstructive pulmonary disease (COPD), arrhythmias and dyslipidemia). We do not know the role played by contextual and individual factors in the prediction of in-hospital mortality. <i>Methods</i>: The present study has added hospital and management factors (year, type of hospital, length of stay, number of diagnoses and procedures, and readmissions) in predicting exitus to establish a structural predictive model. The project was approved by the Ethics Committee of the province of Almeria. <i>Results</i>: A total of 529,606 subjects participated, through databases of the Spanish National Health System. A predictive model was constructed using correlation analysis (SPSS 24.0) and structural equation models (SEM) analysis (AMOS 20.0) that met the appropriate statistical values (chi-square, usually fit indices and the root-mean-square error approximation) which met the criteria of statistical significance. Individual factors, such as age, gender and chronic obstructive pulmonary disease, were found to positively predict mortality risk. Isolated contextual factors (hospitals with a greater number of beds, especially, and also the number of procedures performed, which negatively predicted the risk of death. <i>Conclusions</i>: It was, therefore, possible to introduce contextual variables to explain the behavior of mortality in patients with HF. The size or level of large hospital complexes, as well as procedural effort, are key contextual variables in estimating the risk of mortality in HF. |
| first_indexed | 2024-03-11T02:15:51Z |
| format | Article |
| id | doaj.art-de4043913c1d48f1971ed5d463aa94b2 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T02:15:51Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-de4043913c1d48f1971ed5d463aa94b22023-11-18T11:11:39ZengMDPI AGJournal of Personalized Medicine2075-44262023-06-0113699510.3390/jpm13060995Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart FailureJuan Manuel García-Torrecillas0María Carmen Lea-Pereira1Enrique Alonso-Morillejo2Emilio Moreno-Millán3Jesús de la Fuente-Arias4Emergency and Research Unit, Torrecárdenas University Hospital, 04009 Almería, SpainHospital de Poniente, El Ejido, 04700 Almería, SpainSchool of Psychology, University of Almería, 04120 Almería, SpainEquipo de Investigación SEJ-581, Departamento de Economía Aplicada, Universidad de Almería, 04120 Almería, SpainSchool of Education and Psychology, University of Navarra, 31009 Pamplona, Spain<i>Background</i>: Among the clinical predictors of a heart failure (HF) prognosis, different personal factors have been established in previous research, mainly age, gender, anemia, renal insufficiency and diabetes, as well as mediators (pulmonary embolism, hypertension, chronic obstructive pulmonary disease (COPD), arrhythmias and dyslipidemia). We do not know the role played by contextual and individual factors in the prediction of in-hospital mortality. <i>Methods</i>: The present study has added hospital and management factors (year, type of hospital, length of stay, number of diagnoses and procedures, and readmissions) in predicting exitus to establish a structural predictive model. The project was approved by the Ethics Committee of the province of Almeria. <i>Results</i>: A total of 529,606 subjects participated, through databases of the Spanish National Health System. A predictive model was constructed using correlation analysis (SPSS 24.0) and structural equation models (SEM) analysis (AMOS 20.0) that met the appropriate statistical values (chi-square, usually fit indices and the root-mean-square error approximation) which met the criteria of statistical significance. Individual factors, such as age, gender and chronic obstructive pulmonary disease, were found to positively predict mortality risk. Isolated contextual factors (hospitals with a greater number of beds, especially, and also the number of procedures performed, which negatively predicted the risk of death. <i>Conclusions</i>: It was, therefore, possible to introduce contextual variables to explain the behavior of mortality in patients with HF. The size or level of large hospital complexes, as well as procedural effort, are key contextual variables in estimating the risk of mortality in HF.https://www.mdpi.com/2075-4426/13/6/995SEM analysisheart failurebiomedical factorin-hospital factorsepidemiologymortality |
| spellingShingle | Juan Manuel García-Torrecillas María Carmen Lea-Pereira Enrique Alonso-Morillejo Emilio Moreno-Millán Jesús de la Fuente-Arias Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure Journal of Personalized Medicine SEM analysis heart failure biomedical factor in-hospital factors epidemiology mortality |
| title | Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure |
| title_full | Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure |
| title_fullStr | Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure |
| title_full_unstemmed | Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure |
| title_short | Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure |
| title_sort | structural model of biomedical and contextual factors predicting in hospital mortality due to heart failure |
| topic | SEM analysis heart failure biomedical factor in-hospital factors epidemiology mortality |
| url | https://www.mdpi.com/2075-4426/13/6/995 |
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