TY - JOUR
T1 - Age stratified sex-related differences in incidence, management, and outcomes of cardiogenic shock
AU - Osman, Mohammed
AU - Syed, Moinuddin
AU - Kheiri, Babikir
AU - Bianco, Christopher
AU - Kalra, Ankur
AU - Cigarroa, Joaquin E.
AU - Mamas, Mamas A.
AU - Dawn Abbott, Jinnette
AU - Grines, Cindy L.
AU - Fonarow, Gregg C.
AU - Balla, Sudarshan
N1 - Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Background: There is a lack of data on age-stratified sex differences in the incidence, treatment, and outcomes of cardiogenic shock (CS). We sought to study these differences from a contemporary database. Methods: Patients admitted with CS (2004–2018) were identified from the United States National Inpatient Sample. We compared CS (acute myocardial infarction-related cardiogenic shock [AMI-CS] and non-acute myocardial infarction-related cardiogenic shock [Non-AMI-CS]) incidence, management, and outcomes in males and females, stratified into four age groups (20–44, 45–64, 65–84, and ≥85 years of age). Propensity score matching (PSM) was used for adjustment. Results: A total of 1,506,281 weighted hospitalizations for CS were included (AMI-CS, 39%; Non-AMI-CS, 61%). Across all age groups, females had a lower incidence of CS compared with males. After PSM and among the AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 45–64 (28.5% vs. 26.3%) and 65–84 years (39.3% vs. 37.9%) (p < 0.01, for all). Among the Non-AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 20–44 (33.5% vs. 30.5%), 45–64 (35.1% vs. 31.9%), and 65–84 years (41.7% vs. 40.3%) (p < 0.01, for all). Similar age-dependent differences in the management of CS were also observed between females and males. Conclusions: Females have a lower incidence of CS regardless of age. Significant disparities in the management and outcomes of CS were observed based on sex. However, these disparities varied by age and etiology of CS (AMI-CS vs. Non-AMI-CS) with pronounced disparity among females in the age range of 45–84 years.
AB - Background: There is a lack of data on age-stratified sex differences in the incidence, treatment, and outcomes of cardiogenic shock (CS). We sought to study these differences from a contemporary database. Methods: Patients admitted with CS (2004–2018) were identified from the United States National Inpatient Sample. We compared CS (acute myocardial infarction-related cardiogenic shock [AMI-CS] and non-acute myocardial infarction-related cardiogenic shock [Non-AMI-CS]) incidence, management, and outcomes in males and females, stratified into four age groups (20–44, 45–64, 65–84, and ≥85 years of age). Propensity score matching (PSM) was used for adjustment. Results: A total of 1,506,281 weighted hospitalizations for CS were included (AMI-CS, 39%; Non-AMI-CS, 61%). Across all age groups, females had a lower incidence of CS compared with males. After PSM and among the AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 45–64 (28.5% vs. 26.3%) and 65–84 years (39.3% vs. 37.9%) (p < 0.01, for all). Among the Non-AMI-CS cohort, higher mortality among females compared with males was observed in the age groups 20–44 (33.5% vs. 30.5%), 45–64 (35.1% vs. 31.9%), and 65–84 years (41.7% vs. 40.3%) (p < 0.01, for all). Similar age-dependent differences in the management of CS were also observed between females and males. Conclusions: Females have a lower incidence of CS regardless of age. Significant disparities in the management and outcomes of CS were observed based on sex. However, these disparities varied by age and etiology of CS (AMI-CS vs. Non-AMI-CS) with pronounced disparity among females in the age range of 45–84 years.
KW - National Trends
KW - age
KW - cardiogenic shock
KW - disparity
KW - gender
KW - sex
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U2 - 10.1002/ccd.30177
DO - 10.1002/ccd.30177
M3 - Article
C2 - 35391503
AN - SCOPUS:85128788438
SN - 1522-1946
VL - 99
SP - 1984
EP - 1995
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 7
ER -