Racial Disparities in Outcomes of Cardiac Device Related Infections

Document Type

Article

Abstract

Background: Cardiac device related infection (DRI) is associated with adverse outcomes. Racial differences in in-hospital outcomes have not been adequately studied.

Methods: National Inpatient Sample 2011-2018 was queried with ICD codes for DRI along with procedure code for device implantation or removal/revision/replacement as well as device removal with signs of systemic infection. DRI patients were divided into African American (AA) and non-African American (non-AA) groups. The in-hospital outcomes were compared using logistic regression.

Results: Among 71,007 DRI patients, 13% were AA. Compared to non-AA, AA patients with DRI were older, more often female and had higher burden of comorbidities (Charlson Comorbidity Index ≥3: 59-vs-56%, p<0.001; Table). Congestive heart failure was the most common comorbidity in AA (70-vs-56%, p<0.001). The multivariate analysis showed AA as an independent predictor of higher in-hospital mortality (adjusted OR=1.26, CI 1.1-1.6, p=0.04), mean length of stay (Δ+3.6 days, p<0.001), total hospital cost (Δ +$36,339, p <0.001) and septic shock (adjusted OR=1.25, CI 1.07-1.4, p=0.005) [Table].

Conclusion: Clinical profile of AA patients with DRI differed from those of non-AA patients with DRI. After adjustment for baseline demographic and clinical differences, however, AA race remained an important independent predictor of in-hospital mortality and morbidity. Further studies are needed to delineate the underlying basis of these disparities.

First Page

163

DOI

10.1016/S0735-1097(23)00607-1

Publication Date

3-7-2023

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