Gender Disparity of Automatic Implantable Cardioverter-Defibrillator Placement for Primary Prevention: National Inpatient Sample Analysis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2024-08-05 DOI:10.1159/000540696

Shreya Srivastava, Meghan Nahass, Emily Hiltner, Ankur Sethi, John Kassotis

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引用次数: 0

Abstract

Introduction: Automatic implantable cardioverter-defibrillators (AICDs) for the primary prevention of sudden cardiac death have become standard care for patients with systolic heart failure (sHF) and ejection fraction ≤35%. While the prevalence of sHF and rates of hospitalization are higher in men, one would expect equivalent rates of implantation in women.

Methods: We used the Healthcare Cost and Utilization Project's National Inpatient Sample (NIS) from 2009 to 2018 to identify patient visits with sHF and AICD implantation. The comorbidities and outcomes were compared based on gender.

Results: There were 15,247,854 inpatient admissions for sHF, of which 60.3% were males (95% CI: 60.1%-60.4%) and 39.8% females (95% CI: 39.7%-39.9%). Approximately 2% of patients (294,726) underwent the insertion of an AICD for primary prevention: 72.3% males (95% CI: 71.9%-72.7%) and 27.72% females (95% CI: 27.3%-28.1%). There was no significant difference in age (p = 0.29), length of stay (p = 0.09), and inpatient mortality (p = 0.18).

Conclusion: In this study, women accounted for approximately 40% of patients admitted with the diagnosis of sHF; however, they accounted for less than 30% of patients who underwent the insertion of an AICD. Further research is needed to better understand this gender disparity and identify reasons for the lower rates of AICD placement in women.

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为初级预防而植入自动心律转复除颤器的性别差异：全国住院病人样本分析。

导言：用于初级预防心脏性猝死（SCD）的自动植入式心律转复除颤器（AICD）已成为收缩性心力衰竭（sHF）和射血分数为 35% 的患者的标准治疗方法。虽然男性的收缩性心力衰竭发病率和住院率较高，但我们希望女性的植入率与男性相当。方法我们使用了 2009-2018 年医疗成本与利用项目的全国住院患者样本（NIS），以确定 sHF 和 AICD 植入患者的就诊情况。根据性别对合并疾病和结果进行了比较。结果有15247854名sHF住院患者，其中男性占60.3%（95% CI 60.1%-60.4%），女性占39.8%（95% CI 39.7%-39.9%）。约有 2% 的患者（294,726 人）植入了 AICD 用于一级预防；其中 72.3% 为男性（95% CI 71.9%-72.7%），27.72% 为女性（95% CI 27.3%-28.1%）。年龄（P=0.29）、住院时间（LOS）（P=0.09）和住院死亡率（P=0.18）均无明显差异。结论在这项研究中，被诊断为 sHF 的入院患者中，女性约占 40%，但在植入 AICD 的患者中，女性却不到 30%。要更好地理解这种性别差异并找出女性植入 AICD 的比例较低的原因，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.