拓扑综合征患者临床疗效的种族和民族差异;一项全国性分析。

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Revascularization Medicine Pub Date : 2024-09-24 DOI:10.1016/j.carrev.2024.09.013
Jamal Christopher Perry, Oluwasegun Matthew Akinti, Chukwuka Eneh, Henry Osarumme Aiwuyo, Charles Poluyi, Ukenenye Emmanuel, Esther Doudu, Henry Alberto Becerra, Mustafa Bilal Ozbay, Kibwey Roderick Peterkin, Rosy Thachil, Abdullah Khan
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引用次数: 0

摘要

背景:高突波综合征(TTS)是一种应激诱发的一过性左心室功能障碍,人们对其了解甚少,估计其在急性冠状动脉综合征病例中的发病率为 1-2%。本研究调查了 TTS 住院结果和临床特征的种族和民族差异:我们使用 2016 年至 2020 年的全国住院患者抽样数据进行了一项回顾性队列研究,通过有效的 ICD-10 编码识别 TTS 病例。统计分析使用Stata 18进行,逻辑回归模型调整了混杂因素,以确定结果的差异:该研究包括 32,785 例 TTS 住院病例;其中大多数是白人(80.5%),其次是黑人(6.7%)和西班牙裔(5.8%)患者。少数族裔群体(主要是黑人和西班牙裔患者)更年轻(平均年龄 63 岁),主要来自低收入阶层,而亚洲人的收入阶层最高。美国原住民的住院时间(5.1 天)和总费用(22,707.60 美元)最高。值得注意的发现包括黑人患者的中风率最高(4.8%,OR 2.1,95 % CI 1.2 至 3.4,p = 0.003)。亚裔患者的心源性休克发生率最高(11%,OR 2,95 % CI 1.5 至 2.5,P 结论:亚裔患者的心源性休克发生率最高:在 TTS 的预后方面存在明显的种族和民族差异,少数群体的院内预后更高。这些发现突出表明,迫切需要有针对性的干预措施和进一步研究,以减少 TTS 管理中的医疗不公平现象。
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Racial and ethnic disparities in clinical outcomes among patients with takotsubo syndrome; A nation-wide analysis.

Background: Takotsubo syndrome (TTS), a stress-induced transient left ventricular dysfunction, remains poorly understood, with an estimated incidence of 1-2 % among acute coronary syndrome cases. This study investigates racial and ethnic disparities in hospital outcomes and clinical characteristics of TTS.

Methods: We conducted a retrospective cohort study using the National Inpatient Sample data from 2016 to 2020, identifying TTS cases through validated ICD-10 codes. Statistical analysis was performed using Stata 18, with logistic regression models adjusting for confounders to identify disparities in outcomes.

Results: The study included 32,785 TTS hospitalizations; the majority were White (80.5 %), followed by Black (6.7 %) and Hispanic (5.8 %) patients. Minority groups, mainly Black and Hispanic patients, were younger (average age 63) and predominantly from lower-income brackets, while Asians had the highest income bracket. Length of stay (5.1 days) and Total cost ($22,707.60) were highest among Native Americans. Notable findings include Black patients showing the highest rate of stroke (4.8 %, OR 2.1, 95 % CI 1.2 to 3.4, p = 0.003). The rate of cardiogenic shock was highest among Asians (11 %, OR 2, 95 % CI 1.5 to 2.5, p < 0.001). Mortality rates were elevated in Black (2 %, OR 1.5, 95 % CI 1.3 to 1.7 p < 0.001) and Asian populations (1.8 %, OR 1.97, 95 % CI 1.5 to 2.5, p < 0.001).

Conclusion: Significant racial and ethnic disparities exist in TTS outcomes, with minority groups having more in-hospital outcomes. These findings highlight the urgent need for targeted interventions and further research to reduce healthcare inequities in TTS management.

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来源期刊
Cardiovascular Revascularization Medicine
Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.90%
发文量
687
审稿时长
36 days
期刊介绍: Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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