Trends in mortality among the geriatric population undergoing Surgical aortic valve replacement (SAVR) and potential racial disparities: a 20-year perspective via the National (Nationwide) Inpatient Sample  

作　　者：Nomesh Kumar Kamleshun Ramphul FNU Bawna Nitish Behary Paray Mansimran Si-ngh Dulay Jasninder Singh Dhaliwal Shruti Aggarwal Sebastian Mactaggart Suma Sri Chennapragada Shaheen Sombans Renuka Verma Hemamalini Sakthivel Raheel Ahmed 

机构地区：[1]Department of Internal Medicine,Detroit Medical Center Sinai Grace-Wayne State University,Michigan,USA [2]In-dependent Researcher,Triolet,Mauritius [3]Independent researcher,Farmington Hills,Michigan,USA [4]Royal Devon University Healthcare NHS Foundation Trust,Exeter,United Kingdom [5]Royal Brompton Hospital,part of Guy’s and St.Thomas’NHS Foundation Trust,London,United Kingdom [6]Department of Internal Medicine,University of Cali-fornia,Riverside,USA [7]Independent Researcher,New Delhi,India [8]Northumbria Hospitals NHS Foundation Trust,Newcastle,United Kingdom [9]Department of Internal Medicine,Louisiana State University,Shreveport,USA [10]Sha-heen Sombans,Independent Researcher,Hyderabad,India [11]Department of Internal Medicine,Kirk Kerkorian School of Medicine at UNLV,Las Vegas,USA [12]One Brooklyn Health System/Interfaith Medical Ctr Program,Brooklyn,NY,USA

出　　处：《Journal of Geriatric Cardiology》2024年第7期716-722,共7页老年心脏病学杂志（英文版）

摘　　要：Background Racial disparities in cardiovascular conditions are well documented.Whether similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement(SAVR) for aortic stenosis remains understudied.Methods We abstracted data from the National(Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 codes.We included patients aged ≥ 60 and ≤ 80 years with races recorded as White,African American,or Hispanic at the time of their hospitalization for surgery.We analyzed and reported the baseline characteristics,risk-adjusted inhospital mortality,and complications stratified by race.Results Of 420,181 patients studied,90.0% identified as White,4.0% as African American and 6.0% as Hispanic.Despite a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020,African Americans had higher odds of all-cause in-hospital deaths compared to Whites(a OR = 1.390,P < 0.001).Additionally,they were more likely to experience cardiogenic shock(a OR = 1.241,P < 0.001) and acute kidney injury(a OR = 1.314,P < 0.001) as well as more likely to require organ support such as IABP use(a OR = 1.336,P < 0.001) or invasive mechanical ventilation(a OR = 1.342,P < 0.001).Interestingly,African Americans were less likely to report events of acute ischemic stroke compared to Whites(a OR = 0.852,P < 0.001).Conclusions Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis,racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality.

关 键 词：MORTALITY LIKELY SPITE 

分 类 号：R654.2[医药卫生—外科学]