Abstract 13281: Racial, Gender, or Income Disparities Not Related to Outcomes in the First Year After an Implantable Cardioverter Defibrillator (ICD)
Introduction: Racial, gender, and income disparities among implantable cardioverter defibrillator (ICD) recipients have been widely reported. In particular, African Americans (AA), women, and those with lower socioeconomic status (SES) are less likely to receive an ICD or report poorer outcomes after ICD implant. The purpose of this study was to determine if racial, gender, or income disparities had an impact on number of ICD shocks or all cause hospitalization in the first year after initial ICD implant.
Methods: 300 patients receiving an initial ICD in the Pacific NW were followed for 1 year. Patients were (mean±SD) 64±12 years old, 90% Caucasian, 4% AA, 2% Am Indian (AI), 2% Latino, 75% male, 87% living in urban areas, with 25% employed FT, 10% PT, and 43% retired, averaging $30-49K in household income. ICD shocks and hospitalizations were verified using medical records. Descriptive statistics, Chi2, and correlations were used to examine for health disparities in clinical outcomes over 1 year.
Results: There were no significant associations between race, gender or SES and outcomes of ICD shock or all cause hospitalization within 1 year. For race, 10.7% of Caucasians and 0.7% of all other races received an ICD shock (X2=3.36, p=0.50); 28% of Caucasians, 2.7% of AA, 1.4% AI, and 0.7% Latino were hospitalized (X2=1.57, p=0.81). For gender, 3.4% of women and 9.5% of men received an ICD shock (X2=0.20, p=0.65); 4.7% of women and 29.1% of men were hospitalized (X2=3.0, p=0.08). For SES, 5.6% in $10-29K, 3.5% in $30-49K, and 2.1% in >$90K received an ICD shock (X2=10.3, p=0.07); 6.9% in $10-29K, 11.8% in $30-49K, and 5.6% in >$90K were hospitalized (X2=6.4, p=0.27). Results showed trends (p<.10) of men more likely to be hospitalized and those with lower SES more likely to have ICD shocks in the first year.
Conclusions: We found no statistically significant associations between patient race, gender or income and the incidence of ICD shocks or hospitalizations in the first year post-ICD implant. Other research reveals disparities with respect to who receives an ICD, but these findings reveal no differences in ICD-related outcomes once patients have received an ICD.
Author Disclosures: C.M. Dougherty: None. C.M. Reilly: None. E.A. Thompson: None.
- © 2016 by American Heart Association, Inc.