Mortality rates and hemorrhagic complications in asian-pacific islanders during treatment of acute myocardial infarction**The findings and conclusions of this study do not necessarily represent the views of The Queen's Medical Center.

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place.

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SUN-426 The Impact from AJCC 8Th Edition Staging System on Thyroid Cancer Outcomes by Race And Ethnicity

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.730 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Juan Antonio Santamaria-Barria ◽

Amanda N Graff-Baker ◽

Shu-Ching Chang ◽

Adam Khader ◽

Anthony J Scholer ◽

...

Keyword(s):

Native American ◽

Race And Ethnicity ◽

Proportional Hazards ◽

Staging System ◽

Cox Proportional Hazards ◽

Pacific Islanders ◽

Asian Pacific Islanders ◽

Asian Pacific ◽

The Impact ◽

8Th Edition

Abstract Background. Previous studies have demonstrated racial and ethnic outcome disparities among differentiated thyroid cancer (DTC) patients. However, the impact of the 8th edition of the American Joint Committee on Cancer staging system (AJCC8) on these disparities is unknown. Methods. DTC patients with sufficient tumor and survival data were identified in the National Cancer Database from 2004-2013. The 7th edition of the staging system (AJCC7) and AJCC8 criteria were compared. Multivariable logistic regression was used to evaluate the association between AJCC7 to AJCC8 staging change and race and ethnicity. Cox-proportional hazards regression was then used to evaluate the association between AJCC7 to AJCC8 staging change and overall survival. Results. Of 33,323 DTC patients, 76.7% were White/Non-Hispanics, 7.6% Blacks, 6.7% Hispanics, 5.4% Asian/Pacific-Islanders, and 3.6% Native-American/Other. Most were female (77%) with papillary DTC (90%). After adjusting for demographic, tumor, and treatment characteristics, Hispanics and Asian/Pacific-Islanders were 27% and 12% less likely to be AJCC7 to AJCC8 downstaged than White/Non-Hispanics (OR=0.73, 95%CI: 0.66-0.81; and OR=0.88, 95%CI: 0.79-0.99, respectively); Blacks had no significant downstaging difference compared to White/Non-Hispanics (OR=0.99, 95% CI: 0.90-1.09, p=0.79). Although AJCC8 was a better survival prognosticator than AJCC7, Cox-proportional hazards regression showed that all AJCC7 to AJCC8 downstaged patients had an increased risk of death compared to patients with unchanged staging, regardless of race and ethnicity: White/Non-Hispanics (HR=2.64, 95%CI: 2.34-2.98), Blacks (HR=1.77, 95%CI: 1.23-2.54), Hispanic (HR=3.27, 95%CI: 2.05-5.22), Asian/Pacific-Islanders (HR=2.31, 95%CI: 1.35-3.98), and Native-American/Other (HR=5.26, 95%CI: 2.10-13.19). However, based on two way interaction, the magnitude of negative change in survival from downstaging was only different between White/Non-Hispanics and Blacks (HR=2.64 vs. HR=1.77, respectively; p=0.04). Conclusions. Racial and ethnic outcome disparities persist with AJCC8. The proportion of downstaged DTC patients with AJCC8 varies by race and ethnicity, with the least impact found in Hispanics and Asian/Pacific-Islanders. Downstaged patients across all racial and ethnic groups had a decreased survival than those with unchanged stage, with the least impact in Blacks. These disparities should be taken into account when counseling patients about their prognosis with the new AJCC8.

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Prediction of Hospital Acute Myocardial Infarction and Heart Failure 30-Day Mortality Rates Using Publicly Reported Performance Measures

Journal for Healthcare Quality ◽

10.1111/j.1945-1474.2011.00173.x ◽

2013 ◽

Vol 35 (2) ◽

pp. 15-23 ◽

Cited By ~ 1

Author(s):

David S. Aaronson ◽

Naomi S. Bardach ◽

Grace A. Lin ◽

Arpita Chattopadhyay ◽

Elizabeth L. Goldman ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Performance Measures ◽

Mortality Rates

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Long-Term Mortality Rates Reflect Progressive Prognostic Benefits of Thrombolysis in Patients with First Acute Myocardial Infarction

Cardiology ◽

10.1159/000047302 ◽

2000 ◽

Vol 94 (2) ◽

pp. 111-117 ◽

Cited By ~ 2

Author(s):

Itzhak Shapira ◽

Amos Pines ◽

Uri Goldbourt ◽

Yael Villa ◽

Yaacov Drory

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Mortality Rates ◽

Long Term Mortality

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Short-Term Incidence of Sequelae of HCV Infection Among Medicaid Beneficiaries in Oregon

Public Health Reports ◽

10.1177/0033354918813552 ◽

2018 ◽

Vol 134 (1) ◽

pp. 81-88

Author(s):

Kazuaki Jindai ◽

Courtney Crawford ◽

Ann R. Thomas

Keyword(s):

Cox Regression ◽

Practical Method ◽

Pacific Islanders ◽

Hcv Infection ◽

Incidence Density ◽

High Morbidity ◽

Hazard Ratios ◽

Asian Pacific Islanders ◽

Medicaid Beneficiaries ◽

Asian Pacific

Objectives: Given the known high morbidity and mortality of hepatitis C virus (HCV) infection in Oregon, we sought to develop a practical method of estimating the severe sequelae of HCV infection among Medicaid beneficiaries in Oregon. Methods: We assembled a retrospective cohort that identified all Oregon Medicaid beneficiaries with HCV infection enrolled for at least 1 year during 2009-2013. We linked this cohort to 3 data sets to identify HCV-related deaths, cases of hepatocellular carcinoma (HCC), and first hospitalizations for advanced liver disease (ALD). We calculated incidence density rates and used multivariable Cox regression modeling to calculate adjusted hazard ratios (aHRs) to evaluate the association between demographic characteristics (birth year, sex, race, ethnicity) and these 3 outcomes. Results: Of 11 790 Oregon Medicaid beneficiaries with HCV infection, 474 (4.0%) had an HCV-related death, 156 (1.3%) had HCC, and 596 (5.1%) had a first hospitalization for ALD. Adjusted hazard ratios for deaths were 2.2 (95% confidence interval [CI], 1.6-2.8) among persons born in 1945 through 1965 (vs persons born after 1965), 2.1 (95% CI, 1.7-2.5) among males (vs females), and 1.9 (95% CI, 1.2-2.9) among Asian/Pacific Islanders and 2.2 (95% CI, 1.5-3.2) among American Indian/Alaska Natives (vs white persons). The same risk groups had significant aHRs for first hospitalizations for ALD. Persons born before 1945 (aHR = 17.0; 95% CI, 5.2-55.8) and in 1945 through 1965 (aHR = 12.8; 95% CI, 4.1-40.3) vs born after 1965, males (aHR = 3.3; 95% CI, 2.3-4.8) vs females, and Asian/Pacific Islanders (aHR = 3.9; 95% CI, 2.3-6.7) vs white persons had higher risks for HCC. Conclusions: Continued assessments using the methods piloted in this study will allow Oregon to monitor trends in severe sequelae of HCV infection over time.

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OTHR-10. THE NATIONAL DISTRIBUTION OF NEWLY-DIAGNOSED BRAIN METASTASES IN ADULTS VARIES WIDELY BY PATIENT DEMOGRAPHICS

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.087 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i20-i20

Author(s):

Vasileios Kavouridis ◽

Matthew Torre ◽

Maya Harary ◽

Timothy Smith ◽

Bryan Iorgulescu

Keyword(s):

Brain Metastases ◽

Pacific Islanders ◽

Prior History ◽

National Cancer Database ◽

Newly Diagnosed ◽

Patient Demographics ◽

Asian Pacific Islanders ◽

History Of ◽

Asian Pacific ◽

History Of Cancer

Abstract INTRODUCTION: Metastases are oft-cited as comprising approximately half of all adult intracranial neoplasms, and their national composition remains unclear. METHODS: The patient demographics and histologic distribution of newly-diagnosed brain metastasis (BM) patients aged > 18yo without a prior history of cancer (2010–2015) were evaluated using the National Cancer Database, which comprises > 70% of all newly-diagnosed cancers in the U.S. RESULTS: 91,686 adults presented with a newly-diagnosed BM between 2010–2015. The most common sites of brain metastases overall were lung (82% of metastatic cases), breast (4.1%), melanoma (3.2%), kidney (2.9%), and colorectal (1.8%). The overall 1-year and 5-year OS rates for all BMs were 27.0% (95% CI [26.7%-27.3%]) and 5.3% (95% CI [5.1%-5.5%]), respectively. The distribution of primary sites for newly-diagnosed BMs varied by sex, age, and race. Compared to males, more females had BMs from breast (8.4% versus 0.8%) and fewer had BMs from kidney (1.9% versus 3.8%), melanoma (1.9% versus 4.5%), and esophagus (0.3% versus 2.0%). In young adults, particularly those 20-29yo, BMs were more likely from melanoma, genitourinary (in males), and soft tissue than adults in middle and advanced age. Lung carcinomas comprised fewer BMs in Hispanics (66%) compared to Whites (82%), Blacks (83%), and Asian/Pacific Islanders (85%). BMs from kidney and genitourinary primaries were higher in Hispanics (7.3% and 2.4% of BMs, respectively) than in Whites (2.8% and 0.3%, respectively), Blacks (1.8% and 0.1%, respectively), and Asian/Pacific Islanders (2.6% and 0.2%, respectively). Melanoma was more frequent in Whites (3.8% of BMs) and Hispanics (2.5%) compared to Blacks (0.3%) and Asian/Pacific Islanders (0.6%). CONCLUSION: Our results illustrate the national distribution of newly-diagnosed BMs and investigates how the distribution varies by patient demographics.

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