Key result
Non-white patients undergoing multi-vessel PCI had higher odds of in-hospital mortality, with the highest odds in Hispanic males (OR 1.23) and Asian females (OR 1.51).
Why the study?
Data were limited regarding racial and sex disparities in the outcomes of multi-vessel percutaneous coronary interventions.
Do racial and sex disparities affect resource utilization and clinical outcomes in patients undergoing multi-vessel percutaneous coronary interventions?
Observational (n=769,502)
Yes
Do racial and sex disparities affect resource utilization and clinical outcomes in patients undergoing multi-vessel percutaneous coronary interventions?
Significant racial and sex disparities exist in outcomes and resource utilization for multi-vessel PCI, with non-whites experiencing higher in-hospital mortality and complications despite lower resource utilization.
Answers are grounded in this paper and cite their sources.
Racial/sex disparities in MVPCI mortality and resource use warrant confirmation in prospective cohorts; leaves open whether they reflect access, bias, or biology.
Background: There is a paucity of data regarding the racial and sex disparities in the outcomes of multi-vessel percutaneous coronary interventions (MVPCI). Methods: The National Inpatient Sample (NIS) was examined for the years 2010 to 2014 to incorporate adult MVPCI-related hospitalizations using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes. We excluded patients with the missing race or gender data from the final scrutiny. Discharge weights were used to obtain the national estimations. The principal outcomes were MVPCI-related racial and gender disparities in terms of the in-hospital mortality and complications, and diagnostic and therapeutic healthcare resource utilization. Secondary outcomes were the length of hospital stay (LOS) and hospitalization charges. We used the Chi-square test and t-test/ANOVA test to equate dichotomous and continuous variables respectively. A two-tailed P of <0.05 was considered clinically significant. Results: An estimated 769,502 MVPCI-related hospitalizations were recorded from 2010 to 2014 after excluding patients with the missing data (70,954; 8.4%). Black male and female were the youngest (62±13, 64±14 years). The highest non-elective admissions (M: 72.8%, F: 71.2%) were reported among Hispanics. Non-whites showed a higher proportion of comorbidities with lower resource utilization than whites. Hispanic males (OR 1.23) showed the highest odds of the in-hospital mortality whereas among females, Asians (OR 1.51), blacks (OR 1.35), followed by Hispanics (OR 1.22) revealed higher odds of in-hospital mortality. Odds of cardiac complications were highest amongst Asians (M: OR 1.19, F: OR 1.40). Black (6±8 days) and Hispanic (7±9 days) showed the highest length of stay among males and females respectively. Total hospitalization charges were highest among Asians. There was a greater increase in the all-cause mortality in non-whites from 2010 to 2014. Conclusions: This study determines the existence of racial disparities in resource utilization and outcomes in MVPCI. There is an instant need for interventions designed to govern these healthcare discrepancies.
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Desai et al. (2019) conducted an observational in Multi-vessel percutaneous coronary interventions (n=769,502). Non-white race vs. White race was evaluated on In-hospital mortality and complications, and diagnostic and therapeutic healthcare resource utilization. Non-white patients undergoing multi-vessel PCI had higher odds of in-hospital mortality, with the highest odds in Hispanic males (OR 1.23) and Asian females (OR 1.51).
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