{"title":"早期 COVID-19 大流行期间急性心肌梗死相关结果的性别、种族和地区差异:全国住院病人样本分析。","authors":"Harshith Thyagaturu, Amro Taha, Shafaqat Ali, Nicholas Roma, Sanchit Duhan, Neel Patel, Yasar Sattar, Karthik Gonuguntla, Harigopal Sandhyavenu, Irisha Badu, Erin D Michos, Sudarshan Balla","doi":"10.62347/WKBJ1501","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Disparities in acute myocardial infarction (AMI)-related outcomes have been reported before the COVID-19 pandemic. We studied in-hospital outcomes of AMI across demographic groups in the United States during the early COVID-19 pandemic.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) database was queried for 2020 to identify AMI-related hospitalizations based on appropriate ICD-10-CM codes categorized by sex, race, and hospital region categories. The primary outcome was in-hospital mortality in females, racial and ethnic minority groups, and Northeast hospital region compared with males, White patients, and Midwest hospital region, respectively. Multivariable regression analysis was used to calculate the adjusted odds ratio and mean difference.</p><p><strong>Results: </strong>A total of 820,893 AMI-related hospitalizations were identified during the study period. On adjusted analysis, during the early COVID-19 pandemic, females had lower odds of in-hospital mortality [aOR 0.89 (0.85-0.92); P < 0.01] and revascularization [aOR 0.68 (0.66-0.69); P < 0.01] than males. Racial and ethnic based analysis showed that Asian/Pacific Islander patients had higher odds of in-hospital mortality [aOR 1.13 (1.03-1.25); P < 0.01] than White patients. During the early COVID-19 pandemic, Northeast and Western region hospitals had higher odds of in-hospital mortality, lower odds of revascularization, longer length of stay, and higher total hospitalization costs than Midwest region hospitals.</p><p><strong>Conclusions: </strong>Our study disclosed disparities in AMI-related mortality and revascularization by sex, race and ethnic, and region during the early COVID-19 pandemic. Special attention should be given to at-risk populations. Whether these disparities continue in the post-vaccination era warrants further study.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249665/pdf/","citationCount":"0","resultStr":"{\"title\":\"Disparities by sex, race, and region in acute myocardial infarction-related outcomes during the early COVID-19 pandemic: the national inpatient sample analysis.\",\"authors\":\"Harshith Thyagaturu, Amro Taha, Shafaqat Ali, Nicholas Roma, Sanchit Duhan, Neel Patel, Yasar Sattar, Karthik Gonuguntla, Harigopal Sandhyavenu, Irisha Badu, Erin D Michos, Sudarshan Balla\",\"doi\":\"10.62347/WKBJ1501\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Disparities in acute myocardial infarction (AMI)-related outcomes have been reported before the COVID-19 pandemic. We studied in-hospital outcomes of AMI across demographic groups in the United States during the early COVID-19 pandemic.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) database was queried for 2020 to identify AMI-related hospitalizations based on appropriate ICD-10-CM codes categorized by sex, race, and hospital region categories. The primary outcome was in-hospital mortality in females, racial and ethnic minority groups, and Northeast hospital region compared with males, White patients, and Midwest hospital region, respectively. Multivariable regression analysis was used to calculate the adjusted odds ratio and mean difference.</p><p><strong>Results: </strong>A total of 820,893 AMI-related hospitalizations were identified during the study period. On adjusted analysis, during the early COVID-19 pandemic, females had lower odds of in-hospital mortality [aOR 0.89 (0.85-0.92); P < 0.01] and revascularization [aOR 0.68 (0.66-0.69); P < 0.01] than males. Racial and ethnic based analysis showed that Asian/Pacific Islander patients had higher odds of in-hospital mortality [aOR 1.13 (1.03-1.25); P < 0.01] than White patients. During the early COVID-19 pandemic, Northeast and Western region hospitals had higher odds of in-hospital mortality, lower odds of revascularization, longer length of stay, and higher total hospitalization costs than Midwest region hospitals.</p><p><strong>Conclusions: </strong>Our study disclosed disparities in AMI-related mortality and revascularization by sex, race and ethnic, and region during the early COVID-19 pandemic. Special attention should be given to at-risk populations. Whether these disparities continue in the post-vaccination era warrants further study.</p>\",\"PeriodicalId\":7427,\"journal\":{\"name\":\"American journal of cardiovascular disease\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249665/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of cardiovascular disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.62347/WKBJ1501\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of cardiovascular disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.62347/WKBJ1501","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:在COVID-19大流行之前,就有报道称急性心肌梗死(AMI)相关结果存在差异。我们研究了 COVID-19 大流行早期美国不同人口群体的急性心肌梗死院内预后:方法:我们查询了 2020 年全国住院病人抽样(NIS)数据库,根据适当的 ICD-10-CM 编码,按性别、种族和医院所在地区分类,确定与急性心肌梗死相关的住院病例。主要结果是女性、少数种族和少数民族群体以及东北部医院地区的住院死亡率分别与男性、白人患者和中西部医院地区的住院死亡率进行比较。采用多变量回归分析计算调整后的几率比例和平均差异:结果:研究期间共发现 820,893 例急性心肌梗死相关住院病例。经调整分析,在COVID-19大流行早期,女性的院内死亡率[aOR 0.89 (0.85-0.92); P < 0.01]和血管重建率[aOR 0.68 (0.66-0.69); P < 0.01]低于男性。基于种族和民族的分析显示,亚太裔患者的院内死亡率[aOR 1.13 (1.03-1.25); P < 0.01]高于白人患者。在COVID-19大流行的早期,东北部和西部地区医院的院内死亡几率比中西部地区医院高,血管重建几率比中西部地区医院低,住院时间比中西部地区医院长,住院总费用比中西部地区医院高:我们的研究揭示了在 COVID-19 大流行早期,不同性别、种族、民族和地区在急性心肌梗死相关死亡率和血管再通方面的差异。应特别关注高危人群。这些差异是否会在疫苗接种后继续存在,还需要进一步研究。
Disparities by sex, race, and region in acute myocardial infarction-related outcomes during the early COVID-19 pandemic: the national inpatient sample analysis.
Background: Disparities in acute myocardial infarction (AMI)-related outcomes have been reported before the COVID-19 pandemic. We studied in-hospital outcomes of AMI across demographic groups in the United States during the early COVID-19 pandemic.
Methods: The National Inpatient Sample (NIS) database was queried for 2020 to identify AMI-related hospitalizations based on appropriate ICD-10-CM codes categorized by sex, race, and hospital region categories. The primary outcome was in-hospital mortality in females, racial and ethnic minority groups, and Northeast hospital region compared with males, White patients, and Midwest hospital region, respectively. Multivariable regression analysis was used to calculate the adjusted odds ratio and mean difference.
Results: A total of 820,893 AMI-related hospitalizations were identified during the study period. On adjusted analysis, during the early COVID-19 pandemic, females had lower odds of in-hospital mortality [aOR 0.89 (0.85-0.92); P < 0.01] and revascularization [aOR 0.68 (0.66-0.69); P < 0.01] than males. Racial and ethnic based analysis showed that Asian/Pacific Islander patients had higher odds of in-hospital mortality [aOR 1.13 (1.03-1.25); P < 0.01] than White patients. During the early COVID-19 pandemic, Northeast and Western region hospitals had higher odds of in-hospital mortality, lower odds of revascularization, longer length of stay, and higher total hospitalization costs than Midwest region hospitals.
Conclusions: Our study disclosed disparities in AMI-related mortality and revascularization by sex, race and ethnic, and region during the early COVID-19 pandemic. Special attention should be given to at-risk populations. Whether these disparities continue in the post-vaccination era warrants further study.