Abstract P163: Racial, Gender and Regional Variation in Rates of Cardiovascular Hospitalization Among 9 Million US Veterans
Introduction: Little is known about population-level trends in rates of cardiovascular hospitalizations among U.S. Veterans. Recent adoption of a centralized Corporate Data Warehouse in the Veterans Health Administration (VHA) provides a new opportunity to evaluate trends in national rates of hospitalization among Veterans. We sought to determine the leading causes of cardiovascular (CV) hospitalization, and to compare national rates of CV hospitalization by age, gender, race, ethnicity, geographical distribution and year, among U.S. Veterans.
Methods: We evaluated the electronic health records of all Veterans ≥18 years old that accessed VA healthcare services between January 1 2010 and December 31 2014. Among these 9,066,693 patients, we identified the 5 leading causes of CV hospitalization and compared rates of hospitalization by age, gender, race, ethnicity, geographical distribution and year.
Results: The top 5 causes of CV hospitalization in VA hospitals were: chest pain (3.23 per 1,000 Veterans per year), coronary arteriosclerosis in native artery (2.36), congestive heart failure (1.82), atrial fibrillation (1.34) and acute sub-endocardial infarction (0.99). Overall, the rate of Veterans hospitalized for one or more of these CV conditions decreased over time, from 9.9 per 1000 Veterans in 2010 to 8.3 per 1000 Veterans in 2014. The odds of hospitalization due to any of the 5 conditions were higher in men vs. women (OR 1.73, p<0.0001), in urban vs. rural areas (OR 1.15, p<0.0001), and in the Southeast vs. Pacific regions (OR 1.08, p<0.0001). As compared with Whites, odds of CV hospitalization were higher in Blacks (OR 1.34, p<0.0001) but lower in Asians (OR 0.50, p<0.0001). Racial, geographic and temporal differences in rates of hospitalization were also observed for each of the individual CV conditions.
Conclusions: Among U.S. Veterans enrolled in the VA healthcare system, there is substantial variation in rates of CV hospitalization by age, gender, race, geographical distribution and year.
Author Disclosures: N. Krishnamurthi: None. M.A. Whooley: None.
- © 2017 by American Heart Association, Inc.