There was no significant between-group difference in unadjusted primary end point of 2-year all-cause mortality ( 35 % VA versus 32 % non-VA ; hazard ratio associated with VA hospitals , 1.09 ; 95 % confidence interval , 0.94-1 .26 ) , which remained unchanged after adjustment for age and race ( hazard ratio , 1.00 ; 95 % confidence interval , 0.86-1 .16 ) or multivariable adjustment , including cardiovascular morbidities ( hazard ratio , 0.94 ; 95 % confidence interval , 0.80-1 .10 ) .