Srivastava Geetika, Alhuneafat Laith, Jabri Ahmad, Omar Yazan Abo, Abdolall Ali, Beleny David O, Cunningham Christopher, Al Abdouh Ahmad, Mhanna Mohammed, Siraj Aisha, Kondapaneni Meera, Balakumaran Kathir
Department of Internal Medicine, MetroHealth System/Case Western Reserve University, Cleveland, Ohio.
Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania.
J Soc Cardiovasc Angiogr Interv. 2022 Sep 14;1(6):100451. doi: 10.1016/j.jscai.2022.100451. eCollection 2022 Nov-Dec.
Disparities in acute coronary syndrome (ACS) outcomes exist between racial and ethnic groups. We aimed to evaluate disparities in resource utilization and inpatient outcomes across multiple ethnic and racial groups using contemporary data.
We identified hospital discharges for ACS in the United States using the National Inpatient Sample from 2015 to 2018. The codes were used to identify variables of interest. The primary outcomes were in-hospital complications, length of stay, and total hospital charge. Statistical analysis was performed using STATA version 17.
Our analysis included 1,911,869 ACS discharges. Our sample was made up of 78.6% White, 12.1% Black, and 9.3% Hispanic patients. Hispanic and Black patients presenting with ACS were younger and had more cardiometabolic comorbidities than their White counterparts, especially hypertension, diabetes mellitus, and obesity. Despite social determinants of health being more likely to be unfavorable for Hispanics than their White counterparts, they were more likely to incur higher total hospital charges than their White counterparts. Black patients were the least likely to undergo revascularization procedures. Despite these differences, White patients had higher in-hospital mortality rates than Black and Hispanic patients.
In this nationally representative study, despite having higher cardiometabolic comorbidity burden, lower socioeconomic status, and percutaneous intervention, Black and Hispanic patients experienced lower mortality rates than their White counterparts. Hispanic patients incurred the highest amount of total hospital charges for an ACS admission.
急性冠状动脉综合征（ACS）的治疗结果在不同种族和族裔群体之间存在差异。我们旨在利用当代数据评估多个种族和族裔群体在资源利用和住院治疗结果方面的差异。
我们使用2015年至2018年的全国住院患者样本，确定美国ACS患者的医院出院情况。这些编码用于识别感兴趣的变量。主要结局包括住院并发症、住院时间和总住院费用。使用STATA 17版进行统计分析。
我们的分析包括1,911,869例ACS出院病例。我们的样本由78.6%的白人、12.1%的黑人以及9.3%的西班牙裔患者组成。与白人患者相比，患有ACS的西班牙裔和黑人患者更年轻，且有更多的心脏代谢合并症，尤其是高血压、糖尿病和肥胖症。尽管健康的社会决定因素对西班牙裔患者比对白人患者更不利，但他们的总住院费用却比白人患者更高。黑人患者接受血运重建手术的可能性最小。尽管存在这些差异，但白人患者的住院死亡率高于黑人和西班牙裔患者。
在这项具有全国代表性的研究中，尽管黑人和西班牙裔患者的心脏代谢合并症负担更高、社会经济地位更低且接受经皮干预较少，但他们的死亡率低于白人患者。西班牙裔患者因ACS入院产生的总住院费用最高。
