More patients with cardiovascular disease now die at home than in the hospital

October 09, 2019

Despite their wishes, many patients die in hospitals or other facilities. Cardiovascular disease (CVD) is the leading cause of death both globally and in the U.S., yet little is known about where patients with CVD die. In a new study, Haider Warraich, MD, of Brigham and Women's Hospital, and colleagues assessed place of death for CVD patients from 2003 to 2017, finding that home has surpassed the hospital as the most common place of death for these patients. The results of their analysis are published in the Journal of the American College of Cardiology.

"When I talk to my patients about what's most important to them as they begin to reach the end of life, so many of them tell me they want to spend their last moments surrounded by the familiarity of home," said Warraich, who joined the Division of Cardiovascular Medicine at the Brigham in September as an associate physician. "Understanding where patients die can help us determine how we can deliver care to them and what services they'll require in those settings."

To conduct their study, investigators examined more than 12 million deaths in the Mortality Multiple Cause-of-Death Public Use Record from the National Center for Health Statistics. They looked at whether deaths occurred in a hospital, home, nursing or long-term care facility, inpatient hospice facility, or other (including outpatient medical facility, emergency department, and dead-on-arrival at the hospital). They also analyzed demographic characteristics, including race, ethnicity, sex, marital status, education level and rural-urban status.

The team found that 330,905 CVD deaths occurred in the hospital in 2003, decreasing to 234,703 in 2017. Deaths at home increased from 192,986 in 2003 to 265,133 in 2017, accounting for about 31 percent of the CVD deaths that year. The team also found that underserved racial and ethnic groups were more likely to die in the hospital and less likely to die at home.

Warraich notes that while the data provide insights, they do not reveal what the last days or weeks of patients' life were like and whether they received hospice care at home, nor do the data capture patients' wishes and whether their place of death reflected those wishes.

"Cardiology has lagged behind other specialties in focusing on end-of-life care, but we're now seeing more interest in this important area," said Warraich. "We're seeing that more people are dying at home than at any other location, but we need to better understand what that experience is like so that we can focus our energy on the needs of our patients."
-end-
Paper cited: Cross, SH et al. "Trends in Place of Death for Individuals With Cardiovascular Disease in the United States" Journal of the American College of Cardiology DOI: 10.1016/j.jacc.2019.08.1015

Brigham and Women's Hospital

Related Cardiovascular Disease Articles from Brightsurf:

Changes by income level in cardiovascular disease in US
Researchers examined changes in how common cardiovascular disease was in the highest-income earners compared with the rest of the population in the United States between 1999 and 2016.

Fighting cardiovascular disease with acne drug
Researchers from the European Molecular Biology Laboratory (EMBL) in Heidelberg and Stanford University have found the cause of dilated cardiomyopathy - a leading cause of heart failure - and identified a potential treatment for it: a drug already used to treat acne.

A talk with your GP may prevent cardiovascular disease
Having a general practitioner (GP) who is trained in motivational interviewing may reduce your risk of getting cardiovascular disease.

Dilemma of COVID-19, aging and cardiovascular disease
Whether individuals should continue to take angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the context of coronavirus disease 2019 (COVID-19) is discussed in this article.

Air pollution linked to dementia and cardiovascular disease
People continuously exposed to air pollution are at increased risk of dementia, especially if they also suffer from cardiovascular diseases, according to a study at Karolinska Institutet in Sweden published in the journal JAMA Neurology.

New insights into the effect of aging on cardiovascular disease
Aging adults are more likely to have - and die from - cardiovascular disease than their younger counterparts.

Premature death from cardiovascular disease
National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.

Ultrasound: The potential power for cardiovascular disease therapy
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Despite the ACA, millions of Americans with cardiovascular disease still can't get care
Cardiovascular disease (CVD) is the leading cause of death for Americans, yet millions with CVD or cardiovascular risk factors (CVRF) still can't access the care they need, even years after the implementation of the Affordable Care Act (ACA).

Excess weight and body fat cause cardiovascular disease
In the first Mendelian randomization study to look at this, researchers have found evidence that excess weight and body fat cause a range of heart and blood vessel diseases (rather than just being associated with it).

Read More: Cardiovascular Disease News and Cardiovascular Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.