Unveiling End-of-Life Disparities in Chronic Rheumatic Heart Disease: A 22-Year Analysis of the CDC-WONDER Database

Background This research examines mortality patterns and the place of death in individuals with chronic rheumatic heart disease (RHD) in the United States, aiming to identify demographic predictors for home or hospice death. Additionally, the study aims to uncover trends in mortality due to RHD and provide a predictive forecast. Methods The study utilized data from the Centers for Disease Control and Prevention (CDC)-Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, which spans 22 years (1999-2020), and was categorized based on place of death, including home or hospice care, inpatient, outpatient, or emergency room deaths, and nursing home facility deaths. The data was further analyzed by age, gender, race, and region. The Autoregressive Integrated Moving Average (ARIMA) model was used for statistical analysis and forecasting. Results A total of 73,673 deaths were analyzed, and age was found to be a significant predictor of place of death. The highest number of deaths was in the 85+ age group, followed by a decrease in likelihood with decreasing age. Individuals residing in the West were more likely to die at home or in hospice compared to those in other regions. White individuals had a higher likelihood of dying at home or in hospice compared to other racial groups. Conclusions The findings emphasize the importance of considering patients' preferences and ensuring equitable access to end-of-life care services, regardless of their demographic background. The study highlights the need for further research to improve access to palliative care, reduce disparities in end-of-life care, and enhance the quality of life for individuals with chronic RHD and their families.