Racial and ethnic disparities in utilization of mechanical circulatory support for cardiogenic shock following acute myocardial infarction: A retrospective cross-sectional study
Document Type
Article
Department
Medical College Pakistan
Abstract
Background: Mechanical circulatory support (MCS) is critical in the management of cardiogenic shock (CS) complicating acute myocardial infarction (AMI), but racial/ethnic disparities in MCS utilization remain understudied.
Methods: We extracted data from the National Inpatient Sample database for the years 2018 to 2020. Patients aged ≥18 years with AMI and CS listed as primary or secondary diagnosis were identified using ICD-10-CM. The primary outcome was in-hospital mortality. Secondary outcomes included MCS utilization, hospital length of stay (LOS), total hospital charges, acute kidney injury (AKI)/hemodialysis, and sepsis. Multivariable logistic and linear regression models were used to assess associations between race/ethnicity and in-hospital outcomes.
Results: Among 89 125 hospitalizations for AMI and CS, Hispanics had lower in-hospital mortality than Whites (OR 0.86; 95% CI, 0.76-0.96). The MCS use was higher among Asians or Pacific Islanders (OR 1.35; 95% CI, 1.14-1.60) and Hispanics (OR 1.15; 95% CI, 1.01-1.30) than among Whites. Hispanics had longer LOS (β = 1.3 days; 95% CI, 0.78-1.7), whereas Blacks had shorter stays (β = -0.50 days; 95% CI,-0.91 to -0.10) than Whites. The rates of AKI/hemodialysis were higher among Hispanics (OR 1.26; 95% CI, 1.12-1.42), Blacks (OR 1.59; 95% CI, 1.40-1.79), and Asians or Pacific Islanders (OR 1.39; 95% CI, 1.18-1.64) than Whites. Sepsis rate was greater among Hispanics (OR 1.18; 95% CI, 1.04-1.34). Total hospital charges were higher among Hispanics ($53 770; 95% CI, $39 307-$68 233) and Asians or Pacific Islanders ($33 737; 95% CI, $8954-$58 520), than Whites.
Conclusion: Racial and ethnic disparities in MCS use and clinical outcomes persist among patients with AMI and CS.
Publication (Name of Journal)
Annals of Medicine and Surgery
DOI
10.1097/MS9.0000000000004407
Recommended Citation
Shafiq, A.,
Salman, A.,
Alam, A.,
Qureshi, S.,
Bashir, A. M.,
Bajwa, U.,
Ishaq, B.,
Khan, K.,
Malik, H. W.,
Mubasher, Z.
(2026). Racial and ethnic disparities in utilization of mechanical circulatory support for cardiogenic shock following acute myocardial infarction: A retrospective cross-sectional study. Annals of Medicine and Surgery, 88(1), 179-187.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_mc/563