Date of this Version
Heart & Lung: The Journal of Acute and Critical Care
Evidence of health disparities between urban and rural populations usually favors urban dwellers. The impact of rurality on heart failure (HF) outcomes is unknown.
We compared event-free survival between HF patients living in urban and rural areas.
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.
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.
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.
NOTICE: This is the author’s version of a work that was accepted for publication in Heart & Lung. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in JHeart & Lung, 2010, 39, 512-520, doi: 10.1016/j.hrtlng.2009.11.002
Wu, J., Moser, D. K., Rayens, M., De Jong, M. J., Chung, M. L., Riegel, B., & Lennie, T. A. (2010). Rurality and Event-Free Survival in Patients With Heart Failure. Heart & Lung: The Journal of Acute and Critical Care, 39 (6), 512-520. http://dx.doi.org/10.1016/j.hrtlng.2009.11.002
Date Posted: 01 June 2016
This document has been peer reviewed.