Relationships Between Socioeconomic Status and Cardiovascular Outcomes in Patients with Complete Heart Block.

BACKGROUND

Literature illustrates an association between adverse outcomes and lower socioeconomic status (SES) in patients with critical cardiovascular presentations. Despite this, limited data exists on Complete Heart Block (CHB) outcomes in the context of SES.

OBJECTIVES

We assessed the association of SES (using zip code income quartiles) with the outcomes of CHB cases.

METHODS

We queried the 2016-2019 Nationwide Inpatient Sample and identified CHB as the primary diagnosis. We compared in-hospital outcomes based on zip code mean income quartiles (≤2 (< $59,000) vs. ≥3). The primary outcome was mortality, while secondary outcomes included total and early Permanent Pacemaker (PPM) and Temporary Pacemaker (TPM) use, cardiogenic shock, palliative care involvement, mechanical ventilation use, length of stay (LOS), and total charges. Multivariable regression models were used to adjust for potential confounders.

RESULTS

Of 150,265 CHB hospitalizations, 76,635 (51%) involved patients with a lower income quartile. Lower quartiles were associated with lower odds of early PPM use (adjusted OR [aOR] 0.86, 95% CI 0.81-0.90) and higher odds of in-hospital mortality (aOR 1.23, 95% CI 1.05-1.46), total TPM use (aOR 1.08, 95% CI 1.02-1.14), palliative care (aOR 1.2, 95% CI 1.02-1.43), mechanical ventilation use (aOR 1.11, 95% CI 1.01-1.23), cardiogenic shock (aOR 1.15, 95% CI 1.01 - 1.31), and longer LOS (4 days vs. 3.6 days, p <0.001) compared to patients in higher quartiles.

CONCLUSION

Patients with lower income admitted for CHB were less likely to receive an early PPM and had higher adverse outcomes compared to patients with higher income. (250 words).

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.