A retrospective research found that low-income residents diagnosed with ST-elevation myocardial infarction have significantly higher mortality rates than higher-income inhabitants. The findings were presented today at the 2022 Scientific Sessions of the Society for Cardiovascular Angiography and Interventions.
Low socioeconomic status has been linked to poor cardiovascular disease clinical outcomes. ST-elevation myocardial infarction is a type of heart attack that primarily affects the bottom chambers of the heart and is more severe and dangerous than other heart attacks. While studies show a link between income and co-morbidities, nothing is known about the impact of a patient's income on in-hospital mortality after ST-elevation myocardial infarction.
The authors identified all adult patients admitted with ST-elevation myocardial infarction and grouped them into four quartiles based on the median household income in the patient's zip code. There were 184,150 (35.1%) low-income residents and 123,815 (19.4%) high-income residents among the 639,300 ST-elevation myocardial infarction hospitalizations.
In comparison to the highest income residents, the lowest income residents had higher all-cause mortality, duration of stay, rate of invasive mechanical ventilation, and lower inflation-adjusted cost. The lowest-income residents died at a rate of 11.8 percent, while the highest-income individuals died at a rate of 10.
Age: Residents with the lowest incomes tended to be younger (mean age of 63.5) than those with the highest incomes (mean age of 65.7).
Gender: In the lowest income category (35.7 percent), there were more females than in the highest income group (29.8 percent).
In comparison to the other groups, low-income residents had the highest number of black, Hispanic, and Native American patients and the lowest proportion of white, Asian, and Pacific Islander patients.
In metropolitan areas, residents with the highest income experienced greater hospitalizations.
Modes:
A retrospective analysis of adult discharges from the National Inpatient Sample was conducted between 2016 and 2018 using ICD codes to identify ST-elevation myocardial infarction patients. Study models were adjusted for several patient-level and hospital-level characteristics. Prevalence estimates were weighted using National Inpatient Sample provided discharge-level weights to reflect national estimates.
"This study underscores the growing need to close the health disparities divide that is impacting the patients who live in low-income areas," said MD, with Hattiesburg Clinic Hospital Care Service in Hattiesburg, Miss. and lead researcher of the study. "As physicians, it's imperative that we help everyone get access to high-quality medical care and look with a broader lens at the social and economic factors that could contribute to stark differences in outcomes."
ICD codes were used to identify ST-elevation myocardial infarction patients in a retrospective survey of adult discharges from the National Inpatient Sample between 2016 and 2018. The median household income of the zip code where the patient belonged was used to divide the patients into quartiles. Several patient- and hospital-level factors were factored into the study models. To represent national estimates, prevalence estimates were weighted using National Inpatient Sample provided discharge-level weights.
"This study highlights the rising need to reduce the health inequalities divide that unfairly targets low-income patients," MD, of Hattiesburg Clinic Hospital Care Service in Hattiesburg, Miss., the study's principal researcher. "As physicians, it is critical that we enable everyone in obtaining high-quality healthcare."
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