3.3 Ten-year trends for heart failure outcomes 161 association was found between LOS and in-hospital mortality. (Incidence rate ratio = 1.00, p-value= 0.529, adjusted for age, sex, ethnicity and time trend) Absolute risks for readmission and mortality by age, sex and ethnicity are displayed in Supplementary table 1. Thirty-day readmission rates were higher in men (19.4%) than women (16.4%). Although there were no apparent differences for inpatient mortality by sex (adjusted p=0.340), mortality rates at 30 days and at one year were greater in men than women (11.4% vs 10.9% and 34.7% vs 31.2%, both adjusted p<0.001) (Table 2). Age at index hospitalisation was a significant determinant of both short- and medium-term (one year) mortality. Patients who were on the extreme ends of the age spectrum, i.e., those aged 20-<25 years and 85 years and older had 2.4- and 1.8fold increased risk of in-hospital death compared to those who were between 60 and 65 years. For patients who survived past 30 days, the risk of mortality within a year increased gradually from the 30-<35 years age band (adjusted risk ratio 0.85, 95% CI 0.77 -0.94) to the oldest age band of 85 years and above (adjusted risk ratio 1.58, 95%CI 1.49 -1.67) compared to the reference age category (60-<65 years). By ethnicity, 30-day readmission rates were highest in Indians (19.9%), followed by Chinese (19.5%), Malay (17.9%) and Others (14.5%). For short-term mortality, Others presented with the poorest outcomes: 9.4% for in-hospital mortality and 14.4% for 30-day mortality compared to 4.6% and 10.7% in Malays, the largest ethnic group in Malaysia. This translates to a 1.8-and 1.3-fold increase in risk for mortality relative to Malays when adjusted to age, sex and calendar year. Indian patients, on the other hand, had lower inpatient (3.8%), 30-day (8.4%) and one-year (28.6%) mortality rate than Malays. All ethnic differences in outcome measures remained when estimates were adjusted for age, sex and calendar year.
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