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心房颤动患者在接受导管消融治疗方面的性别、种族和社会经济差异。

Gender, ethnic, and socioeconomic differences in access to catheter ablation therapy in patients with atrial fibrillation.

作者信息

Hamade Hani, Jabri Ahmad, Mishra Pooja, Butt Muhammad Umer, Sallam Sherin, Karim Saima

机构信息

Department of Internal Medicine, The Metrohealth System, Cleveland, OH, United States.

Heart and Vascular Center, The Metrohealth System, Cleveland, OH, United States.

出版信息

Front Cardiovasc Med. 2023 Jan 4;9:966383. doi: 10.3389/fcvm.2022.966383. eCollection 2022.

Abstract

INTRODUCTION

Female patients, patients from racial minorities, and patient with low socioeconomic status have been noted to have less access to catheter ablation for atrial fibrillation.

METHODS

This is a cross-sectional, retrospective study using a large population database (Explorys) to evaluate the gender, racial and socioeconomic differences in access of catheter ablation therapy in patient with atrial fibrillation.

RESULTS

A total of 2.2 million patients were identified as having atrial fibrillation and 62,760 underwent ablation. Females had ablation in 2.1% of cases while males received ablation in 3.4% of cases. Caucasians had ablation in 3.3% of cases, African Americans in 1.5% of cases and other minorities in 1.2% of cases. Individuals on medicaid underwent ablation in 1.6% of cases, individuals on medicare and private insurance had higher rates (2.8 and 2.9%, respectively). Logistic regression showed that female patients (OR 0.608, CI 0.597-0.618, < 0.0001), patients who are African American (OR 0.483, CI 0.465-0.502, < 0.0001), or from other racial minorities (OR 0.343, CI 0.332-0.355, < 0.0001) were less likely to undergo ablation. Patient with medicare (OR 1.444, CI 1.37-1.522, < 0.0001) and private insurance (OR 1.572, CI 1.491-1.658, < 0.0001) were more likely to undergo ablation.

CONCLUSION

Female gender, racial minorities, low socioeconomic status are all associated with lower rates of catheter ablation in management of atrial fibrillation.

摘要

引言

据观察,女性患者、少数族裔患者以及社会经济地位较低的患者接受房颤导管消融治疗的机会较少。

方法

这是一项横断面回顾性研究,使用大型人群数据库(Explorys)评估房颤患者在接受导管消融治疗方面的性别、种族和社会经济差异。

结果

共识别出220万例房颤患者,其中62760例接受了消融治疗。女性患者的消融治疗率为2.1%,男性为3.4%。白人患者的消融治疗率为3.3%,非裔美国人为1.5%,其他少数族裔为1.2%。医疗补助计划覆盖的人群中,消融治疗率为1.6%,医疗保险和私人保险覆盖的人群中消融治疗率较高(分别为2.8%和2.9%)。逻辑回归分析显示,女性患者(比值比0.608,95%置信区间0.597 - 0.618,P < 0.0001)、非裔美国患者(比值比0.483,95%置信区间0.465 - 0.502,P < 0.0001)或其他少数族裔患者(比值比0.343,95%置信区间0.332 - 0.355,P < 0.0001)接受消融治疗的可能性较小。医疗保险覆盖的患者(比值比1.444,95%置信区间1.37 - 1.522,P < 0.0001)和私人保险覆盖的患者(比值比1.572,95%置信区间1.491 - 1.658,P < 0.0001)接受消融治疗的可能性较大。

结论

女性、少数族裔、社会经济地位较低均与房颤治疗中导管消融率较低相关。

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