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Investigating Infection-Related Hospitalization as a Risk Factor for Incident Heart and Mortality Among Heart Failure Patients- [electronic resource]
Investigating Infection-Related Hospitalization as a Risk Factor for Incident Heart and Mo...
Investigating Infection-Related Hospitalization as a Risk Factor for Incident Heart and Mortality Among Heart Failure Patients- [electronic resource]

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자료유형  
 학위논문파일 국외
최종처리일시  
20240214101243
ISBN  
9798379958374
DDC  
614.4
저자명  
Molinsky, Rebecca Lynn.
서명/저자  
Investigating Infection-Related Hospitalization as a Risk Factor for Incident Heart and Mortality Among Heart Failure Patients - [electronic resource]
발행사항  
[S.l.]: : University of Minnesota., 2023
발행사항  
Ann Arbor : : ProQuest Dissertations & Theses,, 2023
형태사항  
1 online resource(178 p.)
주기사항  
Source: Dissertations Abstracts International, Volume: 85-02, Section: B.
주기사항  
Advisor: Demmer, Ryan T.
학위논문주기  
Thesis (Ph.D.)--University of Minnesota, 2023.
사용제한주기  
This item must not be sold to any third party vendors.
초록/해제  
요약HF is a growing epidemic with an estimated prevalence of 6.5 million individuals in the U.S., and poor outcomes persist despite recent therapeutic advancements. Studies have shown that an inflammatory response to infections may become dysregulated, thereby promoting collateral myocardial damage that may result in HF. Infection is also a common cause of hospitalization among HF patients and may lead to poor prognosis and high mortality. Limited data exist examining the relationship between infection-related hospitalization (IRH) and HF along with HF subtypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). Further, few studies have explored mortality rates following an IRH in HF patients or whether certain types of IRH are stronger predictors of mortality. This dissertation leveraged the strengths of large claims data (MarketScan) and a community-based study (ARIC) to address these limitations and parse out the dynamic relationship between infection-related hospitalization and HF with several manuscripts. The first manuscript, a case-crossover study of beneficiaries in the MarketScan databases, assessed the association between IRH and incident HF. IRH was associated with incident HF after both 1- and 3-months. The second manuscript investigated the association between IRH and long-term incident HF in the Atherosclerosis Risk in Communities study (ARIC). IRH was associated with a two-fold greater risk of incident HF, HFrEF, and HFpEF. Findings were stronger among those with HFpEF, for which treatment options are limited. Results from the first manuscript aligned with those of the second manuscript and both found respiratory, pneumonia, and blood/circulatory infections to have the strongest associations with incident HF. The third manuscript explored the relationship between IRH and mortality among HF patients in ARIC. IRH was associated with a two-fold greater risk of mortality among those with HFpEF, HFrEF, or unclassified HF. Respiratory, pneumonia, and other infections had the strongest associations with mortality.Our findings support prior literature linking IRH to HF risk and increased mortality among HF patients. These findings may have significant population-level implications given the high prevalence of IRH and the burden of HF on our aging society. Aim 1: Investigate the association between infection-related hospitalization and incident HF using U.S.-based claims data from MarketScan. Aim 2: Investigate the association between infection-related hospitalization and incident HF and HF subtypes (HFrEF or HFpEF) using a longitudinal community-based cohort study, ARIC.Aim 3: Among HF (HFrEF and HFpEF) patients, investigate the association between infection-related hospitalization and mortality using a longitudinal community-based cohort study, ARIC.
일반주제명  
Epidemiology.
일반주제명  
Biostatistics.
일반주제명  
Medicine.
일반주제명  
Public health.
키워드  
Cox proportional hazards models
키워드  
Heart failure
키워드  
Infection
키워드  
Mortality
키워드  
Aging society
기타저자  
University of Minnesota Epidemiology
기본자료저록  
Dissertations Abstracts International. 85-02B.
기본자료저록  
Dissertation Abstract International
전자적 위치 및 접속  
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MARC

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■00520240214101243
■006m          o    d                
■007cr#unu||||||||
■020    ▼a9798379958374
■035    ▼a(MiAaPQ)AAI30528876
■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a614.4
■1001  ▼aMolinsky,  Rebecca  Lynn.
■24510▼aInvestigating  Infection-Related  Hospitalization  as  a  Risk  Factor  for  Incident  Heart  and  Mortality  Among  Heart  Failure  Patients▼h[electronic  resource]
■260    ▼a[S.l.]:▼bUniversity  of  Minnesota.  ▼c2023
■260  1▼aAnn  Arbor  :▼bProQuest  Dissertations  &  Theses,  ▼c2023
■300    ▼a1  online  resource(178  p.)
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  85-02,  Section:  B.
■500    ▼aAdvisor:  Demmer,  Ryan  T.
■5021  ▼aThesis  (Ph.D.)--University  of  Minnesota,  2023.
■506    ▼aThis  item  must  not  be  sold  to  any  third  party  vendors.
■520    ▼aHF  is  a  growing  epidemic  with  an  estimated  prevalence  of  6.5  million  individuals  in  the  U.S.,  and  poor  outcomes  persist  despite  recent  therapeutic  advancements.  Studies  have  shown  that  an  inflammatory  response  to  infections  may  become  dysregulated,  thereby  promoting  collateral  myocardial  damage  that  may  result  in  HF.  Infection  is  also  a  common  cause  of  hospitalization  among  HF  patients  and  may  lead  to  poor  prognosis  and  high  mortality.  Limited  data  exist  examining  the  relationship  between  infection-related  hospitalization  (IRH)  and  HF  along  with  HF  subtypes,  HF  with  preserved  ejection  fraction  (HFpEF)  and  HF  with  reduced  ejection  fraction  (HFrEF).  Further,  few  studies  have  explored  mortality  rates  following  an  IRH  in  HF  patients  or  whether  certain  types  of  IRH  are  stronger  predictors  of  mortality.  This  dissertation  leveraged  the  strengths  of  large  claims  data  (MarketScan)  and  a  community-based  study  (ARIC)  to  address  these  limitations  and  parse  out  the  dynamic  relationship  between  infection-related  hospitalization  and  HF  with  several  manuscripts. The  first  manuscript,  a  case-crossover  study  of  beneficiaries  in  the  MarketScan  databases,  assessed  the  association  between  IRH  and  incident  HF.  IRH  was  associated  with  incident  HF  after  both  1-  and  3-months.  The  second  manuscript  investigated  the  association  between  IRH  and  long-term  incident  HF  in  the  Atherosclerosis  Risk  in  Communities  study  (ARIC).  IRH  was  associated  with  a  two-fold  greater  risk  of  incident  HF,  HFrEF,  and  HFpEF.  Findings  were  stronger  among  those  with  HFpEF,  for  which  treatment  options  are  limited.  Results  from  the  first  manuscript  aligned  with  those  of  the  second  manuscript  and  both  found  respiratory,  pneumonia,  and  blood/circulatory  infections  to  have  the  strongest  associations  with  incident  HF.  The  third  manuscript  explored  the  relationship  between  IRH  and  mortality  among  HF  patients  in  ARIC.  IRH  was  associated  with  a  two-fold  greater  risk  of  mortality  among  those  with  HFpEF,  HFrEF,  or  unclassified  HF.  Respiratory,  pneumonia,  and  other  infections  had  the  strongest  associations  with  mortality.Our  findings  support  prior  literature  linking  IRH  to  HF  risk  and  increased  mortality  among  HF  patients.  These  findings  may  have  significant  population-level  implications  given  the  high  prevalence  of  IRH  and  the  burden  of  HF  on  our  aging  society. Aim  1:  Investigate  the  association  between  infection-related  hospitalization  and  incident  HF  using  U.S.-based  claims  data  from  MarketScan. Aim  2:  Investigate  the  association  between  infection-related  hospitalization  and  incident  HF  and  HF  subtypes  (HFrEF  or  HFpEF)  using  a  longitudinal  community-based  cohort  study,  ARIC.Aim  3:  Among  HF  (HFrEF  and  HFpEF)  patients,  investigate  the  association  between  infection-related  hospitalization  and  mortality  using  a  longitudinal  community-based  cohort  study,  ARIC.
■590    ▼aSchool  code:  0130.
■650  4▼aEpidemiology.
■650  4▼aBiostatistics.
■650  4▼aMedicine.
■650  4▼aPublic  health.
■653    ▼aCox  proportional  hazards  models
■653    ▼aHeart  failure
■653    ▼aInfection
■653    ▼aMortality
■653    ▼aAging  society
■690    ▼a0766
■690    ▼a0308
■690    ▼a0564
■690    ▼a0573
■71020▼aUniversity  of  Minnesota▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g85-02B.
■773    ▼tDissertation  Abstract  International
■790    ▼a0130
■791    ▼aPh.D.
■792    ▼a2023
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16933406▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.
■980    ▼a202402▼f2024

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