Abstract
Background: Psychiatric diseases are common in patients with heart failure (HF) resulting in higher morbidity and mortality. Disparities in healthcare are well-described in cardiovascular medicine. Minorities often suffer from more frequent mental illnesses. Whether disparities related to gender, racial and socioeconomic status affect outcomes in patients with HF and mental illnesses remains unknown. Methods: We queried ICD-10 codes in the national inpatient sample (2016-2018) for patients with HF and psychiatric disorders including psychotic (F20-29), mood (F30-39), and/or anxiety (F40-43) disorders. Multivariable analysis, adjusting for age and 29 HCUP comorbidities, assessed outcomes of in-hospital mortality, length of stay, and hospital charges based upon gender, race, and household income. Results: Among 685,912 admissions for patients with HF and psychiatric disorders, 63.5% had mood disorders, 55.2% anxiety disorders, and 6.8% psychotic disorders. Mean age was 68.7±14.2 years, 59.8% were females, 75.8% Caucasians, 14.2% African Americans, and 6.6% Hispanics. In multivariable analysis, females, African Americans, Hispanics, and lower median household income were associated with lower in-hospital mortality (Table, p<0.001 for all). There were minimal absolute differences in length of stay and hospital cost (Table). Conclusion: In patients with both HF and psychiatric illness, disparities related to gender, race, and income exist and may modify outcomes. Further data are necessary to determine the impact of these disparities on care delivery among this patient population.
Published Version
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