Abstract 16079: Outcomes Among Heart Failure Patients With Non English Language Preference

Abstract

Introduction: Non-English Language Preference(NELP) has been associated with inequitable care with prior studies highlighting increased risk of readmissions and lower patient satisfaction with care. However, outcomes of patients with heart failure with reduced ejection fraction (HFrEF) who identify as NELP in the United States have not been previously reported. Aims: To evaluate clinical outcomes of HFrEF patients with NELP compared to English-speaking patients. Methods: We performed a single center propensity score matched retrospective cohort study of HFrEF patients who received care between 2010-2022. We compared 5-year mortality, guideline directed medical therapy (GDMT) utilization, length of stay, and readmissions between NELP and English-speaking HFrEF patients. In secondary analyses, we divided NELP by major language group (Spanish, Russian, Other). Results: Our cohort consisted of 2136 English-speaking patients (mean age 82 years, 42% female) and 961 NELP patients (mean age 83 years, 41% female). NELP HFrEF patients had higher rates of angiotensin converting enzyme inhibitor/angiotensin receptor blocker and sodium glucose cotransporter 2 inhibitor use compared to English speakers (Table). Unadjusted 5-year mortality among NELP patients was lower compared to English speakers with a hazard ratio of 0.8 (95% CI 0.68-0.94), but this difference was attenuated after adjusting for race.NELP patients were more likely to have ED visits (69% vs. 65%) but less likely to have inpatient admissions (82% vs 85%) (both p<0.05). In our secondary analysis, Spanish speakers were more likely to be on more GDMT classes compared to English speakers while Russian speakers had increased risk of readmissions and longer length of stay compared to English speakers. Conclusions: NELP patients are heterogeneous with multiple group differences in GDMT use and admissions.Further research is needed to provide culturally-competent, equitable care for HFrEF patients.