Abstract 13015: Sex Disparities in Outcomes of Adults With Cardiogenic Shock Using Impella; a Propensity-Matched Analysis

Abstract

Introduction: Impella use is one of the mechanical circulatory support options in patients with cardiogenic shock (CS). While recent studies have associated a 47.3% short-term mortality in Impella support for CS, there is a lack of data on sex disparities in its use. We, therefore, conducted a retrospective analysis to analyze its impact. Hypothesis: We assessed the hypothesis that females and males have different outcomes following the use of Impella for CS. Methods: We explored the 2016-2020 National Inpatient sample for adults with CS and Impella use. Propensity matching was conducted for multiple patient and hospital characteristics. The differences in males and females for various complications were analyzed. Results: Our study initially found 57630 cases that matched our selection, with 41455(71.9%) males and 16175(28.1%) females. After propensity matching, Females showed a higher mean age (64.31 vs. 62.82 years, p<0.01), with a higher mean Charlson Comorbidity Index (CCI) score (4.50 vs. 4.25, p<0.01), but a shorter hospitalization ( 15.31 vs. 16.64 days). In addition, females showed higher odds of central line-associated bloodstream infection (CLABSI) (aOR 2.576, 95% CI 1.147-5.788, p=0.022), pulmonary embolism (PE) (aOR 1.544, 95% CI 1.077-2.213, p=0.018), respiratory failure/arrest (aOR 1.124, 95% CI 1.001-1.262, p=0.048) than males, while having lower odds of acute kidney injury (AKI) (aOR 0.727, 95% CI 0.648-0.815, p<0.01). No differences in stroke, sepsis, or death events were found between them. Conclusions: In conclusion, there are differences in outcomes between males and females following use of Impella for CS, as females expressed higher odds of CLABSI, PE, respiratory failure/arrest, and lower odds of AKI than males. Future randomized studies in clinical settings and addressing for limitations of our study (such as drug use and duration of various comorbidities) are warranted to improve outcomes between the two cohorts.