Author + information
- Farid Gholitabar,
- Ankit Chothani and
- Angela Palazzo
Background: Gender has been shown to affect the management and outcomes in Non-ST-segment Elevation Myocardial Infarction (NSTEMI). The aim of this study was to determine differences in the outcomes of patients diagnosed with NSTEMI and the effect gender has on these factors.
Methods: This was a retrospective cohort study using the 2013 National Inpatient Sample, the largest publicly available inpatient database in the United States. The inclusion criteria were age older than 18 years and an ICD-9 CM code for any diagnosis of NSTEMI. There were no exclusion criteria. The primary outcome was in-hospital mortality. The secondary outcomes were resource utilization measured by total hospital charges, length of hospital stay (LOS), receiving percutaneous coronary intervention (PCI) and early PCI (defined by PCI received in the first 48 hours of admission). Patients were classified as having NSTEMI diagnosis and not having NSTEMI diagnosis using ICD-9 CM codes. Odds ratios and means were adjusted for the following confounders using multivariate regression analysis models: age, race, Charlson Comorbidity Index, rural location, type of insurance and hospital size.
Results: 418,889 patients with primary diagnosis of NSTEMI were included in the study. The mean age was 68 years. On multivariate analysis, females had no different odds (OR= 0.93 ; P <0.072) of in-hospital mortality compared to male patients. When resource utilization was examined, female patients had lower total hospitalization charges (-10,658 USD; p <0.001) but the LOS was not different (0.15 fewer days; p <0.001). In addition, female patients were less likely to receive PCI (OR= 0.74 ; p <0.001) or early PCI, (OR= 0.74 ; p <0.001).
Conclusions: In the cohort examined, female patients with a primary diagnosis of NSTEMI were less likely to receive PCI and early PCI. In addition, they used fewer hospital resources measured by total charges to the hospital although the LOS is not significantly different. Moreover, there was no significant difference in terms of in-hospital mortality between the two groups.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-343
- 2017 American College of Cardiology Foundation