D-13 | Sex Differences in Outcomes Among Impella Patients: A Retrospective cohort study

Impella is a percutaneously inserted ventricular assist device that is used in cardiogenic shock. There is limited data specifically looking for sex differences in Impella patients. We sought to examine the national inpatient sample database to describe in-hospital outcomes among those patients. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched for hospitalizations of adult patients who underwent Impella placement using international classification of diseases 10th revision codes. Female patients were identified and pregnant patients were excluded. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. Secondary outcomes were hospital length of stay (LOS), and total hospital charges (TOTHCG). SPSS software was used for statistical analysis. Results: This study included 8233 patients who underwent Impella insertion, of which 2346 (28.5 %) were females. Pregnant patients (27 patients) were excluded. Female patients who underwent Impella procedure had higher prevalence of anemia (21.9% Vs. 18.1%, P < 0.001), thyroid disease (12.1% Vs. 10.3%, P < 0.001), and obesity (6.5% Vs. 5.5%, P < 0.001). In-hospital mortality was higher among the female patients (8.5% Vs. 6.0%, P < 0.001). Multivariate regression showed that female patients had higher inpatient mortality (OR 1.492, 95% CI 1.452-1.534, P < 0.001) in addition to paying significantly more TOTHCG ($254,419 VS $225,969, P < 0.001). The mean LOS was longer among the female patients (11.4 days Vs. 10.5 days, P < 0.001). On secondary analysis it has shown that female patients had higher odds of having ventricular arrhythmia (OR 1.326, 95% CI 1.299-1.354, P < 0.001), acute kidney failure (OR 1.359, 95% CI 1.334-1.384, P < 0.001), and stroke (OR 1.473, 95% CI 1.408-1.541, P < 0.001). Conclusions: In this nationally representative population-based retrospective cohort study, female sex was associated with higher mortality and worse outcomes among Impella patients. These findings have important implications, as we strive for equitable care, irrespective of biological sex. Efforts are needed to minimize the excess mortality observed among women. T. Elias, K. Girgis, R. Beshai, M. Daneshvar, M. Lee, Y. Alhamshari, Nothing to disclose.