Abstract 17746: Temporal Trends in Intra-Aortic Balloon Pump Utilization and Persistent Gender Disparities - Data from the Nationwide Inpatient Sample 1997-2009
Intra-Aortic Balloon Pump (IABP) continues to be a critical element in modern management of patients with cardiogenic shock related to acute myocardial infarction (AMI) and acute heart failure (AHF). We examined the temporal trends in IABP usage in the US using a large nationwide database. We also examined potential gender disparities in utilization of this device. Data from the Nationwide Inpatient Sample database (NIS, the largest all-payer, inpatient database in the US) were analyzed to identify all patients who had an IABP implantation during 1997-2009, and patient characteristics were examined in detail for different years. We also examined the temporal trends in discharges related to acute MI, acute heart failure and cardiogenic shock in the US during 1997-2009 as identified by relevant diagnosis related groups (DRG, which are unique to each hospital discharge in the NIS database). We examined potential disparities in IABP usage by calculating the number of IABPs placed for every 100 patients with relevant DRGs. During 1997-2009, a total of 748,127 IABPs were placed in the US, with an average of 57,500 IABPs per year (nonsignificant change across the years). The 65-84-year age group received the highest number of IABPs, followed by the 45-64-year age group. On average, males received twice as many IABPs compared with females, and this difference was consistent across the 13 years of study period (P<0.05) (Figure). The average number of admissions related to acute MI and heart failure was not significantly different between the two genders (763,380 vs. 825,024, P=NS). The number of IABPs placed for every 100 relevant cases was 5.0 for males compared with 2.23 for females (P<0.005). We conclude that significant gender disparities exist in IABP utilization in acute MI and heart failure patients in the US, and this disparity has been persistent across the years. Further studies are warranted to identify the potential factors responsible for such disparity.
- © 2012 by American Heart Association, Inc.