Abstract 18152: Gradual Decline in The Age Adjusted In-hospital Mortality Rate from STEMI Related Cardiogenic Shock Irrespective of Cause, Race or Gender with Persistent Higher Mortality Rates in Women Despite Multivariate Adjustment
Background: Recently we presented reduction in the age adjusted mortality rate in patient with STEMI and all Cause related mortality with persistently higher mortality in women and African American race. The goal of this study was perform multivariate analysis The goal of this study was to evaluate race and gender association after adjusting for co-morbid conditions in multivariate analysis
Method: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted mortality rate of cardiogenic shock from 1996 to 2006 based on ICD-9 coding in the setting of STEMI and cardiogenic shock. We used multivariate analysis adjusting for type 2 diabetes, hyperlipidemia, chronic renal failure, history of CAD, smoking, heart failure, valvular abnormalities and pulmonary hypertension.
Results: We found gradual decrees in mortality over the last 10 years in patients suffering from all cause or STEMI related cardiogenic shock irrespective of gender or race with persistent higher mortality rate for women and African Americans but this association remained significant only for women after multivariate adjustment. .(female gender OR 1.4, CI: 1.2-1.6 , P< 0.001 for year 1996 and OR .1.3, CI: 1.1-1.5, P=001 for year 2006). The age-adjusted mortality rate from STEMI related cardiogenic shock in women was 2,274 per 100,000 in 1996 which declined to lowest level in of 1,724 per 100.000 in 2006 (p<0.01). The age-adjusted mortality rate from STEMI related cardiogenic shock in men was 1,755 per 100,000 in 1996 which declined to the lowest level of 1,459 per 100.000 in 2006 (p<0.01).
Conclusion: Age adjusted in-hospital mortality has been gradually declining in patients presenting with all cause or STEMI related cardiogenic shock over the last 10 years irrespective of gender or race. However, women have persistently higher mortality despite multivariate adjustment warranting further investigation.
- © 2012 by American Heart Association, Inc.