Author + information
- Srikanth Yandrapalli,
- Sohaib Tariq,
- Venkat Lakshmi Kishan Vuddanda,
- Abdallah Sanaani,
- Zeeshan Solangi,
- Viswajit Reddy Anugu,
- Pratik Mondal,
- Merita Shehu,
- Sachin Sule and
- Wilbert Aronow
Background: Acute rheumatic heart disease (ARHD) is a serious manifestation of acute rheumatic fever (ARF) and can result in long-term cardiac complications. Literature suggests that the incidence of ARF is declining in the United States (US). However, the secular variation of ARHD has not been investigated in the US.
Methods: Using the US. Nationwide Inpatient Sample databases from 2003 through 2012 and appropriate ICD-9 codes (390, 391.x, 392.x), we identified hospitalizations with a primary discharge diagnosis of ARF or ARHD. Hospitalizations primarily for ARF which also had a diagnosis of ARHD were identified and analyzed as a separate cohort. Regression analysis was used to analyze outcomes.
Results: Hospitalizations for ARHD represented a very small proportion (0.002%) of the total hospitalizations in the US between the years 2003-2012. Hospitalizations for ARHD have decreased by around 50% between 2003-2012 (Ptrend<0.005). Of the 11,186 hospitalizations for ARF (mean patient age 46±28 years; 53.8% women; 50.4% white), a primary or secondary diagnosis of ARHD was present in 6,866 (61.4%) (mean patient age 55±27 years; 57.4% women; 54.2% white). ARHD in ARF patients decreased from 63% in 2003 to 55.9% in 2012 (Ptrend< 0.005). Among patients hospitalized for ARF, the likelihood of having ARHD is increased in female sex and white race (both P<0.005). ARHD is more common (28%, P<0.005) in patients in the lowest quartile of median household income (US $ 1-38,999). Among patients hospitalized for ARF, ARHD is an independent predictor of increased length of stay (8.4±9.9 vs 6.8±8.5 days in patients with and without ARHD, respectively, P<0.005), increased total hospital charges (US $ 62,926±107,516 vs 46,482±88,796, P<0.005), and increased in-hospital mortality (4.7% vs 3% in patients with and without ARHD, respectively, P<0.005).
Conclusions: ARHD is uncommon in the US and hospitalizations for ARHD have declined between 2003 and 2012. ARHD is common in patients with ARF and is associated with an increased length of stay, hospital charges, and in-hospital mortality. More aggressive preventive interventions in low-income areas might help further reduce the burden of this disease.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-051
- 2017 American College of Cardiology Foundation