室性心动过速消融术中的性别、种族和城乡差异。

IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS JACC. Clinical electrophysiology Pub Date : 2024-10-01 DOI:10.1016/j.jacep.2024.05.033
Amber B. Tang MD , Olumuyiwa P. Akinrimisi MD, MS , Boback Ziaeian MD, PhD
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引用次数: 0

摘要

背景:室性消融术可用于复发性室性心动过速(VT)患者的临床治疗,并已证明可降低复发风险和总体发病率。然而,接受心室消融术的患者之间是否存在差异尚未得到很好的描述:在这项研究中,我们对因 VT 住院的患者进行了调查,以确定接受消融术的患者之间是否存在差异:我们使用全国住院病人样本对 2019 年因主要诊断为 VT 而住院的患者进行了评估,这些患者接受和未接受导管消融术。根据年龄、性别、种族/民族、社会经济状况和医院特征,采用多元逻辑回归计算VT消融的风险因素:调整基线特征和合并症后,与男性和白人患者相比,女性和黑人VT住院患者接受消融术的几率明显较低(OR:0.835;95% CI:0.699-0.997;P = 0.047;OR:0.617;95% CI:0.457-0.832;P = 0.002)。此外,与城市教学医院的患者相比,农村或非教学医院的患者接受消融治疗的可能性明显较低。在调整后的模型中,收入或保险状况无明显差异:我们发现VT住院患者在接受心室消融术方面存在明显差异。总体而言,女性或黑人患者以及在农村或非教学医院住院的患者在住院期间接受 VT 消融术的可能性明显较低。
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Sex, Race, and Rural-Urban Disparities in Ventricular Tachycardia Ablations

Background

Ventricular ablation may be clinically indicated for patients with recurrent ventricular tachycardia (VT) and has been shown to decrease risk of recurrence and overall morbidity. However, the existence of disparities among patients receiving ventricular ablation has not been well characterized.

Objectives

In this study, the authors examined patients hospitalized with VT to determine whether disparities exist among those receiving ablations.

Methods

The authors used the National Inpatient Sample to assess patients hospitalized with a primary diagnosis of VT in 2019 who did and did not receive catheter ablations. Multiple logistic regression was used to calculate risk factors for VT ablation based on age, sex, race/ethnicity, socioeconomic status, and hospital characteristics.

Results

After adjusting for baseline characteristics and comorbidities, female and Black patients hospitalized with VT had significantly lower odds of receiving ablations compared with male and White patients (OR: 0.835; 95% CI: 0.699-0.997; P = 0.047; and OR: 0.617; 95% CI: 0.457-0.832; P = 0.002, respectively). Additionally, patients at rural or nonteaching hospitals were significantly less likely to receive ablations compared with those at urban, teaching hospitals. No significant differences were noted based on income or insurance status in the adjusted models.

Conclusions

The authors identified significant disparities in the delivery of ventricular ablations among patients hospitalized with VT. Overall, patients who were female or Black as well as those who were hospitalized at rural or nonteaching hospitals were significantly less likely to receive VT ablations during hospitalization.
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来源期刊
JACC. Clinical electrophysiology
JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
10.30
自引率
5.70%
发文量
250
期刊介绍: JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.
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