Socioeconomic Risk Factors and Cardiovascular Outcomes in Australia

Muthalaly, Rahul G.; Nelson, Adam; Baradi, A.; Mehta, Ojas; O’Regan, Declan P.; Wilson, A.; Nasis, Arthur

doi:10.2139/ssrn.4133615

Cited by 1 publication

(2 citation statements)

References 9 publications

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“…Moreover, lower-income patients are more likely to have comorbidities, especially cardiovascular diseases, impacting surgical outcomes. [44][45][46] Socioeconomic disadvantage is also associated with poor compliance with medication and lifestyle restrictions crucial for postoperative recovery. Our study observed a higher proportion of lower-income patients in hospitals with higher RDI, especially in quintiles 4 and 5, providing insights into our research findings.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly evident in complex procedures like SAVR and TAVI, requiring multiple visits and extensive preoperative testing. Moreover, lower‐income patients are more likely to have comorbidities, especially cardiovascular diseases, impacting surgical outcomes 44‐46 . Socioeconomic disadvantage is also associated with poor compliance with medication and lifestyle restrictions crucial for postoperative recovery.…”

Section: Discussionmentioning

confidence: 99%

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Association between hospital racial composition and aortic valve replacement outcomes: A national inpatients sample database analysis

Chen,

Xiao,

Huang

et al. 2024

Cathet Cardio Intervent

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BackgroundRacial and ethnic disparities exist in the outcomes following surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). However, it is unclear whether hospital racial composition contributes to these racial disparities.MethodsWe analyzed the National Inpatient Sample (NIS) database from 2015 to 2019 to identify patients with aortic stenosis (AS) who received SAVR and TAVI. The Racial/Ethnic Diversity Index (RDI) was used to assess hospital racial composition as the proportion of nonwhite patients to total hospital admissions. Hospitals were categorized into RDI quintiles. Textbook outcome (TO) was defined as no in‐hospital mortality, no postoperative complications and no prolonged length of stay (LOS). Multivariable mixed generalized linear models were conducted to assess the association between RDI and post‐SAVR and post‐TAVI outcomes. Moreover, quantile regression was used to assess the additional cost and length of stay associated with the RDI quintile.ResultsThe study included 82,502 SAVR or TAVI performed across 3285 hospitals, with 47.4% isolated SAVR and 52.5% isolated TAVI. After adjustment, quintiles 4 and 5 demonstrated significantly lower odds of TO than the lowest RDI quintile in both the SAVR cohort (quintile 4, 0.79 [95% CI, 0.73–0.85]; quintile 5, 0.79 [95% CI, 0.73–0.86]) and TAVI cohort (quintile 4, 0.88 [95% CI, 0.82–0.95]; quintile 5, 0.80 [95% CI, 0.74–0.86]). Despite non‐observable differences in in‐hospital mortality across all RDI quintiles, the rate of AKI and blood transfusion increased with increasing RDI for both cohorts. Further, Higher RDI quintiles were associated with increased costs and longer LOS. From 2015 to 2019, post‐TAVI outcomes improved across all RDI quintiles.ConclusionsHospitals with a higher RDI experienced lower TO achievements, increased AKI, and blood transfusion, along with extended LOS and higher costs. Importantly, post‐TAVI outcomes improved from 2015 to 2019 across all RDI groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%