Racial and ethnic differences in the prevalence, management, and outcomes in patients with atrial fibrillation: A systematic review

Ugowe, Francis; Jackson, Larry R.; Thomas, Kevin L.

doi:10.1016/j.hrthm.2018.05.019

Cited by 75 publications

(59 citation statements)

References 62 publications

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“…Results from this study align with a large body of literature related to racial disparities and health outcomes which has consistently showed disparities among Black, Hispanic, and Multiracial/Other race/ethnicities, compared to Whites. 13,14 Our results are also in agreement with previous research that has established links between race and inequities in safety and accessibility of transportation, including walking, 15 and neighborhood social inequities, traffic volumes, road design, and road traffic injuries. 8 For example, a study of nearly 50,000 U.S. pedestrian deaths using CDC annual mortality data (1999-2015) found significant disparities in death rates by racial/ethnic groups, with higher rates among Blacks, Latinos, and Native Americans, compared to Whites.…”

Section: Resultssupporting

confidence: 92%

Racial disparities in pedestrian-related injury hospitalizations in the United States

Hamann

Peek‐Asa

Butcher

2020

Preprint

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Background. Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity.Methods. Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries.Results. Hospitalization rates were The burden of injury was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Extreme and major loss of function proportions were also highest among Black and Multiracial/Other groups.Discussion. Results from this study show racial disparities in pedestrian injury hospitalizations and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Section: Resultssupporting

confidence: 92%

Racial disparities in pedestrian-related injury hospitalizations in the United States

Hamann

Peek‐Asa

Butcher

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Results from this study align with a large body of literature related to racial disparities and health outcomes, which has consistently shown length of stay and cost disparities among Black, Hispanic, and Multiracial/Other race/ethnicities, compared to Whites [12,13]. A study of nearly 50,000 U.S. pedestrian deaths using CDC annual mortality data (1999-2015) found significant disparities in death rates by racial/ethnic groups, with higher rates among Blacks, Latinos, and Native Americans, compared to Whites [14], whereas our results showed similar racial/ethnic disparities in injury severity and burden of injury among pedestrian hospitalizations with higher costs per capita, longer lengths of stay, and increased mortality among Blacks, Hispanics, and Multiracial/Others, compared to Whites.…”

Section: Discussionsupporting

confidence: 80%

Racial disparities in pedestrian-related injury hospitalizations in the United States

2020

View full text Add to dashboard Cite

Background Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity. Methods Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009–2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries. Results The annual average of pedestrian-related deaths exceeded 5000 per year and hospitalizations exceeded 47,000 admissions per year. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89–1.94) and 1.20 (95% CI: 1.19–1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%). Conclusions Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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“…Though unexplored in previous research, this increased burden may contribute to disparities that exist across race and ethnicity in AF. ( Ugowe, Jackson, & Thomas, 2018 ; Goli, Thompson, & Sears, 2012 ; Golwala, Jackson, & Simon, 2016 For instance, there is strong evidence that in AF, racial/ethnic minorities have a 24–60 % higher risk of stroke, 2–4 times higher risk of intracranial hemorrhage and 46 % higher risk of death. ( Ugowe et al, 2018 ) Additionally, racial/ethnic minorities report significantly more impaired functional status and poorer quality of life.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

Bamgbade

Sanghai

McManus

et al. 2020

Archives of Gerontology and Geriatrics

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Background: Depression, anxiety, and cognitive impairments occur in up to 40 % of adults with AF and are associated with poorer health-related quality of life (HRQoL) and higher symptom burden. However, it is unknown how often these impairments co-occur, or multimorbidity, and how multimorbidity effects HRQoL and symptom burden. Methods: Patients with AF age ≥65 years with a CHA 2 DS 2 VASC risk score ≥ 2 and eligible for oral anticoagulation therapy were recruited from five clinics in a prospective cohort study. Participants completed validated measures of depression (PHQ9) and anxiety (GAD7), cognitive impairment (MoCA), and HRQOL and AF symptom burden (AFEQT). Multinomial logistic regression was used. Results: Participants (N = 1244, 49 % female) were on average 76 ± 7 years; 86 % were non-Hispanic white. Approximately 35 % of participants had 1 impairment, 17 % had 2 impairments and 8% had 3 impairments; 39 % had none of the 3 impairments examined. Compared to participants with no impairments, patients with 1, 2 and 3 impairments had higher odds of poor HRQoL (adjusted OR [AOR] = 1.77, 95 % CI 1.21, 2.60; AOR = 6.64, 95 % CI 4.43, 9.96; and AOR = 7.50, 95 % CI 4.40, 12.77, respectively) and those with 2 and 3 impairments had higher odds of high symptom burden (AOR = 3.69 95 % CI 2.22, 6.13; and AOR = 5.41 95 % CI 2.85, 10.26). Conclusions: Psychosocial/cognitive multimorbidity is common among older adults with AF and is associated with poor HRQoL and high symptom burden. Clinicians might consider incorporating psychosocial and cognitive screens into routine care as this may identify a high-risk population.

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Racial and ethnic differences in the prevalence, management, and outcomes in patients with atrial fibrillation: A systematic review

Cited by 75 publications

References 62 publications

Racial disparities in pedestrian-related injury hospitalizations in the United States

Racial disparities in pedestrian-related injury hospitalizations in the United States

Racial disparities in pedestrian-related injury hospitalizations in the United States

Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

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