scholarly journals RACIAL DIFFERENCES AND THE RISK OF IN-HOSPITAL MORTALITY IN TAKOTSUBO CARDIOMYOPATHY: ANALYSIS FROM THE NATIONAL INPATIENT SAMPLE 2012 DATABASE

2016 ◽  
Vol 67 (13) ◽  
pp. 1518
Author(s):  
Akram Elgendy ◽  
Robert Hamburger ◽  
Islam Elgendy ◽  
Ahmed Mahmoud
Angiology ◽  
2018 ◽  
Vol 70 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Naoki Misumida ◽  
Gbolahan O. Ogunbayo ◽  
Sun Moon Kim ◽  
Ahmed Abdel-Latif ◽  
Khaled M. Ziada ◽  
...  

Takotsubo cardiomyopathy (TC) is definitively diagnosed following the exclusion of acute coronary syndrome. We aimed to examine the rate of coronary angiography in patients diagnosed with TC and also the outcome of patients with TC diagnosed with or without coronary angiography. We analyzed the National Inpatient Sample database from 2010 to 2014 and identified patients hospitalized with a primary diagnosis of TC. We compared in-hospital mortality between patients who underwent coronary angiography and those who did not. We also evaluated the association between coronary angiography and in-hospital mortality using a propensity score–adjusted multivariable analysis. Among 22 818 patients diagnosed with TC, 87.4% underwent coronary angiography and 12.6% did not. Patients who did not undergo coronary angiography had a higher in-hospital mortality than those who did (3.0% vs 0.9%; P < .001). Increased mortality in patients who did not undergo coronary angiogram was observed in both male (8.0% vs 2.8%; P = .03) and female patients (2.6% vs 0.7%; P < .001) and in patients 61 to 80 years old and ≥81 years old, but not in patients ≤60 years old. Multivariable analysis demonstrated that the lack of coronary angiography was independently associated with higher in-hospital mortality (adjusted odds ratio: 2.92; 95% confidence interval: 1.52-5.65; P = .001).


2021 ◽  
Vol 77 (18) ◽  
pp. 1120
Author(s):  
Waqas Ullah ◽  
Salman Zahid ◽  
David Fischman ◽  
Ihab Hamzeh ◽  
Yochai Birnbaum ◽  
...  

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Nandakumar Nagaraja ◽  
Urvish K Patel

Background/Purpose: Although cerebral amyloid angiopathy (CAA) and Alzheimer’s Disease (AD) can manifest as separate diseases it can co-exist due to shared amyloid β pathogenic mechanisms. We assessed admission rates and outcomes of ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) among hospitalized patients with a secondary diagnosis of AD and CAA. Methods: Adult patients discharged with a secondary diagnosis of CAA or AD in National Inpatient Sample (NIS) in the years 2016 and 2017 were identified. Admission rates for IS, ICH, and SAH were primary outcomes. In-hospital mortality and discharge to home were secondary outcomes. Multivariate logistic regression analysis was performed to evaluate secondary outcomes with model adjusted for demographics, medical history, hospital characteristics, and Elixhauser comorbidity index. Results: Among 60,609,519 admissions in NIS, 893,834 (1.5%) patients had a secondary diagnosis of AD [mean age 82.1 years and 62% women] and 14,850 (0.02%) patients had CAA [mean age 76.2 years and 51% women]. Combined AD+CAA was present in 1,335 (0.002%) patients. Compared to AD and controls (non AD or CAA), patients with CAA had higher admission rates for IS (11.5% CAA vs 2.8% AD vs 1.7% control, p<0.0001), for ICH (29.5% CAA vs 0.4% AD vs 0.2% control, p<0.0001) and for SAH (3% CAA vs 0.1% AD vs 0.1% control, p<0.0001). Among patients admitted for IS, discharge to home was less likely in AD compared to controls (10.4% AD vs 36.3% control, OR=0.40; 95%CI=0.36-0.44). Among patients admitted for ICH, discharge to home was less likely in AD compared to controls (6.3% AD vs 18.5% control, OR=0.57; 95%CI=0.41-0.78) but higher in CAA (17.8% CAA vs 18.5% control, OR=1.35; 95%CI=1.11-1.63). In-hospital mortality was less likely in patients with CAA than controls among patients admitted for ICH (9.6% CAA vs 23% control, OR=0.33; 95%CI=0.26-0.41) and SAH (6.7% CAA vs 19.1% control, OR=0.27; 95%CI=0.11-0.62). Conclusion: Admissions for IS, ICH, and SAH were higher among CAA compared to AD in NIS. CAA patients had lower in-hospital mortality for ICH and SAH admissions and higher rates of home discharge for ICH admissions. AD patients were less likely to be discharged home for IS and ICH admissions.


2017 ◽  
Vol 121 (suppl_1) ◽  
Author(s):  
Akintunde M Akinjero ◽  
Oluwole Adegbala ◽  
Nike E Akinjero ◽  
Eseosa Edo-Osagie ◽  
Tomi Akinyemiju

Background: The prognosis of Takotsubo Cardiomyopathy (TTCM) is worse than in the general population. It is unclear how atrial fibrillation (AF) impacts this prognosis. We sought to evaluate the effect of concurrent AF on outcomes in patients with TTCM. Methods: We used the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) to extract all hospitalizations between 2007 and 2011 with concurrent diagnosis of AF and TTCM. The ICD-9 CM codes for AF and TTCM were used. We compared patients admitted for TTCM who had coexisting AF to those without. We excluded patients below the age of 18 as well as those diagnosed with TTCM who later underwent percutaneous coronary intervention (PCI). Multivariate regression was used to assess the independent effect of coexisting AF on clinical outcomes (length of stay (LOS), stroke, and in-hospital mortality). Results: A total of 13,136 TTCM patients were studied. Of these, 2,083 (15.86%) had coexisting AF. Compared with those without, TTCM patients with coexisting AF had a greater multivariate-adjusted risk for increased stroke rate (aOR=1.66, 95% CI=1.27-2.18, Table 1). We found no significant association with in-hospital mortality (aOR=1.21, 95% CI=0.96-1.52) or LOS (aOR=1.21, 95% CI= 0.83-1.58). Conclusions: In this large, nationally representative study, we found higher stroke rates in patients with coexisting AF and TTCM. Our findings suggest the need for closer monitoring during hospitalization.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Thyagaturu ◽  
S Thangjui ◽  
B Shrestha ◽  
K Shah ◽  
R Naik ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cannabis is being more widely use as a recreational substance worldwide. There have been case reports and systematic review describing the association of cannabis use and cardiac arrhythmia (1). Purpose We sought out to measure the prevalence of different types of cardiac arrhythmia in hospitalizations associated with cannabis use disorder. Methods We queried January 2016 to December 2018 National Inpatient Sample (NIS) databases to identify adult (≥18 yrs) hospitalizations in the US with a diagnosis of cannabis use related disorders. Patients with an associated diagnosis of arrhythmias were also identified based on appropriate ICD-10 CM codes. We used the Chi-square test to evaluate the differences between binary or categorical variables, and Student’s t-test for continuous variables. Multivariate logistic regression was used in outcomes analysis to adjust for potential hospital and patient-level confounders (age, sex, race, diabetes, heart failure, chronic kidney disease, anemia, obesity, elixhauser co-morbidity index, hospital location, teaching status, bed size, income status and others). The discharge weights provided in the databases were used to calculate the national estimates. STATA 16.1 software was used to perform all statistical analysis. Results We identified 2,457,544 hospitalizations associated with cannabis use related disorders across three years. Of which, 187,825 (7.6%) were associated with any arrhythmia. We found that atrial fibrillation was the most associated arrhythmia. The complete list of types of arrhythmia and their prevalence are described in Figure-1. Patients with arrhythmia group were older (mean age 50.5 vs 38.3 yrs; P &lt; 0.01) and had higher co-morbidity (% of &gt;3 Elixhauser comorbidity score 94.1% vs 60.6%; P &lt; 0.01). After adjusting for patient and hospital-level confounders, we observed arrhythmia group was associated with higher odds of in-hospital mortality compared to the group without arrhythmia [Odds Ratio (OR): 4.5 (4.09 – 5.00); P &lt; 0.01]. We also observed statistically significant increase in hospitalization length of stay due to the status of any arrhythmia [5.7 vs 5.1 days; P &lt; 0.01]. Conclusion The prevalence of Afib is high in hospitalizations associated with cannabis use. Hospitalizations associated with cannabis use disorder and any arrhythmia are associated with higher in-hospital mortality and LOS. Therefore, all electrocardiograms should be scrutinized in hospitalized cannabis users. However, further prospective studies are necessary to endorse our study results. Abstract Figure.


Author(s):  
Dilip K Pandey ◽  
Venkatesh Aiyagari

Background: Compared to Non-Hispanic whites (NHW), intracerebral hemorrhage (ICH) has a higher incidence among African Americans (AA) where it also occurs at a younger age. Previous studies have concluded that there are no racial differences in hospital mortality after ICH, but the influence of race on disability and discharge disposition after ICH has not been studied. Methods: The Illinois Capture-Stroke registry is a prospectively collected database of patients admitted with a stroke to 56 acute care hospitals in Illinois. We performed a retrospective analysis of the association between race, and in-hospital mortality, modified Rankin Scale (mRS) score at discharge and discharge disposition in 804 patients with ICH enrolled in the registry between 2005 and 2007. Results: We studied 530 NHW and 175 AA patients with radiologically proven ICH. Compared to NHW, AA patients were younger (mean age NHW: 73±14 vs AA: 58±12 yrs, p <0.001) and had a higher incidence of hypertension, smoking and coronary artery disease. Although there was no racial difference in hospital mortality, incidence of moderate to severe disability (mRS 4-5) was significantly higher in NHW (69%) compared to AA (55%). Among patients <65 years old, a trend (p=0.102) towards a higher disability in NHW was observed (60% in NHW vs. 45% in AA). In this age group, 41% of NHW and 33% of AA were discharged to rehabilitation facilities while 37% of NHW and 44% of AA were discharged home. Conclusion: A very large proportion of patients with ICH are discharged from hospitals with moderate or severe disability. Compared to NHW, a higher proportion of younger AA patients are discharged home after ICH. The long term outcomes of survivors after ICH in the United States is not well studied, and the influence of racial and socioeconomic factors on long-term treatment and outcome after ICH needs to be explored.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nilay Kumar ◽  
Rohan Khera ◽  
Neetika Garg

Background and objectives: Heart failure (HF) incidence is higher among Blacks compared to Whites. There is a paucity of recent data on racial differences in in-hospital mortality and resource utilization in a nationally representative, multiracial cohort of HF hospitalizations. Hypothesis: There are significant racial-ethnic differences in HF hospitalization outcomes. Methods: We used the 2011-2012 Nationwide/National Inpatient Sample to identify hospitalizations with a primary diagnosis of HF using relevant ICD-9 codes. Outcomes of interest were in-hospital mortality, length of stay (LOS) and mean inflation adjusted charges. The effect of race on outcomes was ascertained using logistic or linear regression. Results: 375,740 primary HF hospitalizations representing 1.8 million hospitalizations nationwide were included. Mean age was 72.6 (SD 14.6) years and 50.1% were females. After adjusting for age, sex, hypertension, diabetes, APR-DRG mortality risk and socioeconomic status, in-hospital mortality was significantly lower for Blacks (OR 0.69, 95% CI 0.64 - 0.74; p<0.001), Hispanics (OR 0.82, 95% CI 0.75 - 0.91; p<0.001) and Asians or Pacific Islanders (OR 0.85, 95% CI 0.73 - 0.99; p=0.04) compared to Whites. Average inflation adjusted charges were significantly higher for all minorities compared to Whites except for Native Americans for whom charges were significantly lower than Whites (p<0.05 for Black, Hispanic, Asian, NA or Others vs. Whites). LOS was modestly higher for Blacks or Other races vs. Whites (p=0.01 B vs. W and Others vs. W) and lower for Native Americans vs. Whites (p<0.001). Conclusions: Blacks, Hispanics and Asians hospitalized for HF are significantly less likely to die in the hospital compared to Whites. Hospital charges for racial-ethnic minorities are significantly higher compared to Whites. The reasons for racial differences in HF hospitalization outcomes require further investigation.


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