1. Racial disparities in the use of mechanical circulatory support devices in cardiogenic shock
- Author
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Jignesh Patel, Chad Harris, N Patel, Robert Frankel, Jacob Shani, Hitesh Raheja, Arsalan Talib Hashmi, Maham Akbar Waheed, Sanchit V. Kundal, and Bilal Malik
- Subjects
medicine.medical_specialty ,business.industry ,Cardiogenic shock ,Internal medicine ,Circulatory system ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Abstract
Background Racial bias has always been a concern for healthcare. Lack of guideline directed utilization of mechanical circulatory support (MCS) devices in cardiogenic shock (CS) may lead to implicit and racial bias. Purpose To identify the racial differences in the use of mechanical circulatory support in cardiogenic shock and its association with outcomes. Methods National Inpatient Database from 2015–2018 using ICD 10 codes was used. Patients >18 years of age admitted for cariogenic shock were included. Results Among 1,021,274 patients hospitalized for cardiogenic shock, overall MCS was utilized in 11.4% (N=116,539). Use of MCS for patients stratified by race was 12.2% white (N=85543), 8% Blacks (N=14688), 11.3% Hispanics (N=11067), 13.8% Asian (N=4417), 12.3% Native American (N=825). IABP was the most commonly used MCS device, followed by Impella, ECMO and LVAD. Overall odds of MCS insertion was significantly higher in white population [1.18 (1.13–1.23) Conclusion(s) There still exist significant racial differences in the use of mechanical circulatory devices for cardiogenic shock potentially leading to significantly higher mortality in black population compared to whites. This difference in mortality is mitigated with equal use of MCS devices in cardiogenic shock among all races. Funding Acknowledgement Type of funding sources: None.
- Published
- 2021