Outcomes and resource utilization in ST-elevation myocardial infarction in the United States: evidence for socioeconomic disparities.
Bottom Line: There was a significantly higher mortality among the lowest SES quartile as compared to the highest quartile (OR [95% CI]: 1.11 [1.06 to 1.17]).Furthermore, the mean adjusted cost of hospitalization among quartiles 2, 3, and 4, as compared to quartile 1 was significantly higher by $913, $2140, and $4070, respectively.The cost of hospitalization of patients from higher SES quartiles was significantly higher than those from lower quartiles.
Affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (S.A., W.A.J., V.M.).Show MeSH
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Mentions: Sensitivity analysis was performed by comparing the primary outcomes between the study groups after removing all patients who presented as a “transfer” from another healthcare facility. There was no significant change in the trend of the incidence of the primary outcomes across the SES quartiles with this sensitivity analysis (Figure 2). Figure 1 also demonstrates the utilization of percutaneous assist/intra‐aortic balloon pump and Swan Ganz catheterization, stratified by SES quartiles. As seen in this figure, there was a progressively reduced utilization of both modalities among patients from lower SES quartiles as compared to higher quartiles. The incidence of cardiogenic shock accompanying STEMI in SES quartiles 1 to 4 was similar at 8.4%, 8.3%, 8.4%, and 8.8%, respectively (P‐trend: 0.08).
Affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (S.A., W.A.J., V.M.).