Cardiovascular Disease Admissions Research Articles

Epidemiology of cardiovascular diseases related admissions in a tertiary hospital in Hadramout Governorate, Yemen

Background: Cardiovascular diseases (CVDs) are a major challenge confronting physicians in Hadramout Governorate. Little is known about the admission for CVD and outcome at Hadramout Modern Hospital. The aim of this study was to determine the frequency and pattern of CVD admissions in Hadramout Modern Hospital, Hadramout, Yemen. Materials and Methods: This retrospective cross-sectional study included all adult patients admitted for CVDs in the medical ward of Hadramout Modern Hospital from January 01 to December 31, 2023. Results: During the study period, a total of 1020 patients were admitted to the medical word, of which 158 (15.5%) cases were admitted with CVDs. There were 87 (55.1%) males, and the mean age was 58.09±15.08 years. There was a significant age difference between men and women (61.4 years vs. 54.04 years, p=0.002). The most commonly affected age group was those aged 55–64 (32.4%). Uncontrolled hypertension (81.6%), stroke (52.5%), heart failure (37.3%), and acute myocardial infarction (AMI) (36.1%) were the most common CVDs. The mean hospital stay was 7.93±2.83 (2–15 days). There were 220 total deaths in Hadramout Modern Hospital during the study period. Among them, 12 (5.5%) were due to CVDs with no significant sex difference (4 [5.6%] vs. 8 [9.2%]; p=0.549). Conclusion: Given the increasing burden of CVDs in our hospital, it is crucial to understand the epidemiological features of CVDs and their etiological factors to prioritize further research, prevention, and treatment strategies. Additionally, further research is needed in other governorates across the country to identify regions with the highest regional burden of CVDs so that policymakers can reallocate limited resources accordingly.

Cardiovascular admission risk attributable to hot apparent temperature: a study in a rural area of northwest China

ABSTRACT Cardiovascular disease (CVD) is the leading cause of mortality worldwide, posing a significant threat to public health. Research on the relationship between CVD and temperature has primarily focused on developed urban settings, with limited studies conducted in rural regions with lower levels of development. Additionally, compared to relative risks, attributable risks can provide more information when assessing the risk of CVD hospitalizations associated with exposure to apparent temperature (AT). Apparent temperature is a composite temperature index that takes into account both meteorological factors and temperature, providing an objective reflection of human thermal sensation. Therefore, this study investigates the impact of AT on CVD hospitalization and quantifies the burden of CVD admission in the rural areas of China. We employed the distributed lag non-linear model (DLNM) to estimate the relationship between AT and the relative risk (RR) of CVD hospitalization. Finally, we used attributable risk methods to quantify this relationship further.

Emerging trends in nationwide mortality, limb loss, and resource utilization for critical limb ischemia in young adults

Background/objectivesRecent trends indicate a rise in the incidence of critical limb ischemia (CLI) among younger adults. This study examines trends in CLI hospitalization and outcomes among young adults with peripheral arterial disease (PAD) in the United States. MethodsAdult hospitalizations (18–40 years) for PAD/CLI were analyzed from the 2016–2020 nationwide inpatient sample database using ICD-10 codes. Rates were reported per 1000 PAD or 100,000 cardiovascular disease admissions. Outcomes included trends in mortality, major amputations, revascularization, length of hospital stay (LOS), and hospital costs (THC). We used the Jonckheere–Terpstra tests for trend analysis and adjusted costs to the 2020 dollar using the consumer price index. ResultsApproximately 63,045 PAD and 20,455 CLI admissions were analyzed. The mean age of the CLI cohort was 32.7 ± 3 years. The majority (12,907; 63.1 %) were female and white (11,843; 57.9 %). Annual CLI rates showed an uptrend with 3265 hospitalizations (227 per 1000 PAD hospitalizations, 22.7 %) in 2016 to 4474 (252 per 1000 PAD hospitalizations, 25.2 %) in 2020 (Ptrend<0.001), along with an increase in PAD admissions from 14,405 (188 per 100,000, 0.19 %) in 2016 to 17,745 (232 per 100,000, 0.23 %%) in 2020 (Ptrend<0.0001). Annual in-hospital mortality increased from 570 (2.8 %) in 2016 to 803 (3.9 %) in 2020 (Ptrend = 0.001) while amputations increased from 1084 (33.2 %) in 2016 to 1995 (44.6 %) in 2020 (Ptrend<0.001). Mean LOS increased from 5.1 (SD 2.7) days in 2016 to 6.5 (SD 0.9) days in 2020 (Ptrend = 0.002). The mean THC for CLI increased from $50,873 to $69,262 in 2020 (Ptrend<0.001). The endovascular revascularization rates decreased from 11.5 % (525 cases) in 2016 to 10.7 % (635 cases) in 2020 (Ptrend = 0.025). Surgical revascularization rates also increased from 4.9 % (225 cases) in 2016 to 10.4 % (600 cases) in 2020 (Ptrend = 0.041). ConclusionHospitalization and outcomes for CLI worsened among young adults during the study period. There is an urgent need to enhance surveillance for risk factors of PAD in this age group.

Abstract P450: Assessing Admission Risk in Under-Resourced Neighborhoods: An Analysis by Race

Introduction: Cardiovascular disease (CVD) disproportionately affects socioeconomically disadvantaged communities and people of racial minority backgrounds. The Area Deprivation Index (ADI) is a validated measure of census-level characteristics based on income, education, employment, housing, and more. Although ADI is often linked to adversity, it is less well known if ADI is associated with racial disparities in CVD admission among cardiac patients living in disadvantaged communities. Hypothesis: We hypothesized that among a cohort of cardiac patients, risk for CVD admissions would be associated with ADI and that risk would vary by race. Methods: We identified ADI among n=27694 patients receiving care in a large health care system. We compared individual’s demographic variables using chi square for categorical variables and t-test for continuous variables. Using, ANOVA we determined differences in ADI by race. We further used ADI to identify neighborhoods with disproportionate rates CVD admissions using linear regression. Results: Figure Panel A shows that the ADI of American Indians, Blacks, and Asians was higher compared with that of Whites. Completion of an ANOVA test provided a p-value &lt;0.05, showing that the average ADI is not equal between race groups. Panel B shows a linear association between higher ADI and increased risk of CVD event. Yet, some block groups were outliers with lower than predicted CVD events, labeled as low utilizers. Conclusion and Implications: Racial minority groups tended to have a higher ADI, yet some groups at high risk for CVD had disproportionately lower CVD events. These findings along with our team’s future work will inform interventions to address neighborhood level social determinants of cardiac health. Interventions that account for the unique social and healthcare contexts and inequities specific to at-risk communities will in turn help address the health challenges unique to these groups.

Association between Ambient Volatile Organic Compounds Exposome and Emergency Hospital Admissions for Cardiovascular Disease.

The limited research on volatile organic compounds (VOCs) has not taken into account the interactions between constituents. We used the weighted quantile sum (WQS) model and generalized linear model (GLM) to quantify the joint effects of ambient VOCs exposome and identify the substances that play key roles. For a 0 day lag, a quartile increase of WQS index for n-alkanes, iso/anti-alkanes, aromatic, halogenated aromatic hydrocarbons, halogenated saturated chain hydrocarbons, and halogenated unsaturated chain hydrocarbons were associated with 1.09% (95% CI: 0.13, 2.06%), 0.98% (95% CI: 0.22, 1.74%), 0.92% (95% CI: 0.14, 1.69%), 1.03% (95% CI: 0.14, 1.93%), 1.69% (95% CI: 0.48, 2.91%), and 1.85% (95% CI: 0.93, 2.79%) increase in cardiovascular disease (CVD) emergency hospital admissions, respectively. Independent effects of key substances on CVD-related emergency hospital admissions were also reported. In particular, an interquartile range increase in 1,1,1-trichloroethane, methylene chloride, styrene, and methylcyclohexane is associated with a greater risk of CVD-associated emergency hospital admissions [3.30% (95% CI: 1.93, 4.69%), 3.84% (95% CI: 1.21, 6.53%), 5.62% (95% CI: 1.35, 10.06%), 8.68% (95% CI: 3.74, 13.86%), respectively]. We found that even if ambient VOCs are present at a considerably low concentration, they can cause cardiovascular damage. This should prompt governments to establish and improve concentration standards for VOCs and their sources. At the same time, policies should be introduced to limit VOCs emission to protect public health.

Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: population based cohort study

ObjectiveTo estimate exposure-response associations between chronic exposure to fine particulate matter (PM2.5) and risks of the first hospital admission for major cardiovascular disease (CVD) subtypes.DesignPopulation based cohort study.SettingContiguous US.Participants59 761...

Urban–rural disparities in the association of nitrogen dioxide exposure with cardiovascular disease risk in China: effect size and economic burden

BackgroundTogether with rapid urbanization, ambient nitrogen dioxide (NO2) exposure has become a growing health threat. However, little is known about the urban–rural disparities in the health implications of short-term NO2 exposure. This study aimed to compare the association between short-term NO2 exposure and hospitalization for cardiovascular disease (CVD) among urban and rural residents in Shandong Province, China. Then, this study further explored the urban–rural disparities in the economic burden attributed to NO2 and the explanation for the disparities.MethodsDaily hospitalization data were obtained from an electronic medical records dataset covering a population of 5 million. In total, 303,217 hospital admissions for CVD were analyzed. A three-stage time-series analytic approach was used to estimate the county-level association and the attributed economic burden.ResultsFor every 10-μg/m3 increase in NO2 concentrations, this study observed a significant percentage increase in hospital admissions on the day of exposure of 1.42% (95% CI 0.92 to 1.92%) for CVD. The effect size was slightly higher in urban areas, while the urban–rural difference was not significant. However, a more pronounced displacement phenomenon was found in rural areas, and the economic burden attributed to NO2 was significantly higher in urban areas. At an annual average NO2 concentration of 10 μg/m3, total hospital days and expenses in urban areas were reduced by 81,801 (44,831 to 118,191) days and 60,121 (33,002 to 86,729) thousand CNY, respectively, almost twice as much as in rural areas. Due to disadvantages in socioeconomic status and medical resources, despite similar air pollution levels in the urban and rural areas of our sample sites, the rural population tended to spend less on hospitalization services.ConclusionsShort-term exposure to ambient NO2 could lead to considerable health impacts in either urban or rural areas of Shandong Province, China. Moreover, urban–rural differences in socioeconomic status and medical resources contributed to the urban–rural disparities in the economic burden attributed to NO2 exposure. The health implications of NO2 exposure are a social problem in addition to an environmental problem. Thus, this study suggests a coordinated intervention system that targets environmental and social inequality factors simultaneously.

Effect of short-term exposure to air pollution on hospital admission for cardiovascular disease: A time-series study in Xiangyang, China

BackgroundData on the relationship between short-term exposure to air pollution and cardiovascular diseases (CVDs) and the potential modifying factors are limited and inconsistent. ObjectiveTo explore the relationship between short-term exposure to air pollution and CVD risk, and potential modification effect factors. MethodA time series study was conducted on 52,991 hospital admissions for CVD from 2015 to 2019 in Xiangyang City, China. Air pollution data from four national fixed monitoring stations were collected to estimate exposure level in Xiangyang City. A quasi-Poisson generalized additive model incorporating a distributed lag nonlinear model was applied to evaluate the association between air pollution and CVD risk. The potential modification effect of sex, age, and season on the above associations was also evaluated. ResultsCVD risk was positively associated with air pollution. Peak associations in single lag day structures were observed for particulate matter ≤10 μm in aerodynamic (PM10; RR: 1.040, 95 % CI: 0.996–1.087), PM2.5 (1.025, 1.004–1.045), nitrogen dioxide (NO2; 1.074, 1.039–1.111), and sulfur dioxide (SO2; 1.079, 1.019–1.141) at Lag 0 and ozone (O3; 1.018, 1.004–1.031) at Lag 4. In cumulative lag day structures, the highest RRs were 1.225 (1.079,1.392) for PM10 at Lag 06, 1.054 (1.013, 1.098) for PM2.5 at Lag 03, 1.200 (1.119, 1.287) for NO2 at Lag 04, and 1.135 (1.025, 1.257) for SO2 at Lag 02. Moreover, the association between air pollution and CVD risk was modified by sex and age (P < 0.05). Females and individuals aged ≤65 years were more vulnerable to NO2 and had a higher CVD risk. ConclusionShort-term exposure to air pollution was positively associated with CVD risk. Moreover, sex and age could modify the effect of air pollution on CVD risk. Females and individuals aged ≤65 years had a higher NO2 exposure-induced CVD risk.

Association Between Air Pollution and Cardiovascular Disease Hospitalizations in Lanzhou City, 2013-2020: A Time Series Analysis.

Extensive evidence has shown that air pollution increases the risk of cardiovascular disease (CVD) admissions. We aimed to explore the short-term effect of air pollution on CVD admissions in Lanzhou residents and their lag effects. Meteorological data, air pollution data, and a total of 309,561 daily hospitalizations for CVD among urban residents in Lanzhou were collected from 2013 to 2020. Distributed lag non-linear model was used to analyze the relationship between air pollutants and CVD admissions, stratified by gender, age, and season. PM2.5, NO2, and CO have the strongest harmful effects at lag03, while SO2 at lag3. The relative risks of CVD admissions were 1.0013(95% CI: 1.0003, 1.0023), 1.0032(95% CI: 1.0008, 1.0056), and 1.0040(95% CI: 1.0024, 1.0057) when PM2.5, SO2, and NO2 concentrations were increased by 10μg/m³, respectively. Each 1mg/m3 increase in CO concentration was associated with a relative risk of cardiovascular hospitalization of risk was 1.0909(95% CI: 1.0367, 1.1479). We observed a relative risk of 0.9981(95% CI: 0.9972, 0.9991) for each 10μg/m³ increase in O3 for CVD admissions at lag06. We found a significant lag effects of air pollutants on CVD admissions. NO2 and CO pose a greater risk of hospitalization for women, while PM2.5 and SO2 have a greater impact on men. PM2.5, NO2, and CO have a greater impact on CVD admissions in individuals aged <65years, whereas SO2 affects those aged ≥65years. Our research indicates a possible short-term impact of air pollution on CVD. Local public health and environmental policies should take these preliminary findings into account.

Socioeconomic disparity in mortality and the burden of cardiovascular disease: analysis of the Prospective Urban Rural Epidemiology (PURE)-China cohort study

Although socioeconomic inequality in cardiovascular health has long been a public health focus, the differences in cardiovascular-disease burden and mortality between people with different socioeconomic statuses has yet to be adequately addressed. We aimed to assess the effects of socioeconomic status, measured via three socioeconomic-status indicators (ie, education, occupation, and household wealth and a composite socioeconomic-status disparity index, on mortality and cardiovascular-disease burden (ie, incidence, mortality, and admission to hospital) in China. For this analysis, we used data from the Prospective Urban Rural Epidemiology (PURE)-China cohort study, which enrolled adults aged 35-70 years from 115 urban and rural areas in 12 provinces in China between Jan 1, 2005, and Dec 31, 2009. Final follow-up was on Aug 30, 2021. Indicators of socioeconomic status were education, occupation, and household wealth; these individual indicators were also used to create an integrated socioeconomic-status index via latent class analysis. Standard questionnaires administered by trained researchers were used to obtain baseline data and were supplemeted by physical measurements. The primary outcomes were all-cause mortality, cardiovascular-disease mortality, non-cardiovascular-disease mortality, major cardiovascular disease, and cardiovascular-disease admission to hospital. Hazard ratios (HRs) and average marginal effects were used to assess the association between the primary outcomes and socioeconomic status. Of 47 931 participants enrolled in the PURE-China study, 47 278 (98·6%) had complete information on sex and follow-up. After excluding 1189 (2·5%) participants with missing data on education, household wealth, and occupation at baseline, 46 089 participants were included in this analysis. Median follow-up was 11·9 years (IQR 9·5-12·6); 26 860 (58·3%) of 46 089 participants were female and 19 229 (41·7%) were male. Having no or primary education, unskilled occupation, or being in the lowest third of household wealth was associated with a higher risk of all-cause mortality, cardiovascular-disease mortality, non-cardiovascular-disease mortality, major cardiovascular disease, and cardiovascular-disease admission to hospital compared with having higher education, a professional or managerial occupation, or more household wealth. After adjustment for confounders, people categorised as having low integrated socioeconomic status based on the index had a higher risk of all-cause mortality (HR 1·65 [95% CI 1·42-1·92]), cardiovascular-disease mortality (2·19 [1·68-2·85]), non-cardiovascular disease mortality (1·43 [1·18-1·72]), major cardiovascular disease (1·43 [1·27-1·61]) and cardiovascular-disease admission to hospital (1·14 [1·01-1·28]) compared with people categorised as having high integrated socioeconomic status. Socioeconomic-status inequalities in mortality and cardiovascular-disease outcomes exist in China. Targeted policies of equal health-care resource allocation should be promoted to equitably benefit people with fewer years of education and less household wealth. Funding sources are listed at the end of the Article.

The impact of cancer on the risk of hospitalisation for bleeding among acute coronary syndrome patients: an analysis of the Virtual Cardio-Oncology Research Initiative (VICORI) database

Abstract Introduction Cardiovascular disease and cancer are common causes of morbidity and mortality. Significant advancements in treatment strategies for both disease entities have resulted in a growing population who live with both conditions. Myocardial infarction (MI) represents approximately 20% of all cardiovascular disease admissions in cancer patients and 10% of patients who present with an acute MI has cancer. Bleeding is a major concern in patients with cancer and an acute coronary syndrome (ACS). While dual antiplatelet therapy (DAPT) increases a patient’s bleeding risk, cancer patients are at a further increased risk. Cancer is a recognised risk factor associated with an increased bleeding risk after percutaneous coronary intervention (PCI), but blood dyscrasias, liver disease and multiple long-term conditions – all common to cancer patients – further exacerbate this risk. Prescribing DAPT post-ACS and post-PCI remains a challenge when balancing ischaemic and bleeding risks in this population. The VICORI database is the world’s first whole-country cardio-oncology research platform, linking data from the National Cancer Registration and Analysis Service, National Institute for Cardiovascular Outcomes Research and Hospital Episode Statistics [1]. Purpose To investigate the risk of hospitalisation for bleeding among ACS patients stratified by presence or absence of cancer. Methods This is an observational cohort study using linked data from the VICORI programme. We explored the risk of hospitalisation for bleeding following an ACS, in patients with and without cancer, identified between 2006–2019. Patients were followed up for one year from the date of their ACS. We used inverse probability weighting based on propensity scores to produce a balanced cohort of patients with and without cancer. Subgroup analyses were performed on patients with ST and non-ST-elevation MI alongside coronary stenting. Results Of 608,771 patients presenting with ACS, 9861 (1.6%) had cancer and 598,910 (98.4%) did not have cancer. Prostate (n=1753, 17.8%), colorectal (n=1548, 15.7%), lung (n=1543, 15.7%) and breast (n=607, 6.2%) cancers were the most common types of primary cancers. Relating to PCI, cancer patients received stents in only 35.4% (n=3,489) of cases, while non-cancer patients received stents in 55.5% (n=332,566) of cases. Bleeding events were more prevalent in cancer patients compared to non-cancer patients (n=779, 7.9% vs n=28,016, 4.7%). The rate (hazard) of hospitalisation for bleeding in the first year following ACS was higher in patients with cancer than those without (HR:1.46, 95%CI 1.36-1.57). Conclusion In this large real-world observational study, cancer patients had an increased risk of hospitalisation for bleeding after ACS compared to those without. Further work is needed to identify people with cancer who are at a high-risk of bleeding, optimal therapies, and the risk:benefit ratio of bleeding versus subsequent cardiovascular events.Incidence Rate of Bleeding in PatientsHazard Ratios for Bleeding

Hospital admissions among people with diabetes: A systematic review.

To describe the reasons for hospital admission among people with diabetes. We searched Emcare, Embase, Medline and Google Scholar databases for population-based studies describing the causes of hospitalisation among people with diabetes. We included articles published in English from 1980 to 2022. For each study, we determined the most frequent reasons for admission. Studies were assessed for quality using the Newcastle Ottawa quality assessment tool. 6920 research articles were retrieved from the search of all sources. After screening the titles and abstracts of these, we reviewed the full text of 135 papers and finally included data from 42 studies. Admissions among the total diabetes were reported in 25 papers: 5 articles reported type 1 diabetes alone, 10 articles reported type 2 diabetes alone and the remaining 2 articles reported type 1 and type 2 diabetes separately. Among the 25 total and type 2 diabetes studies that reported the distribution of hospitalisations in broad categories, cardiovascular diseases (CVD) were the leading cause of admission in 19/25 (76%) of studies. Among the 19 studies that reported CVD admissions by subcategories, ischaemic or coronary heart disease was the leading subtype of CVD in 58% of studies. The other common causes of admissions were infections, renal disorders, endocrine, nutritional, metabolic and immunity disorders. In people with type 1 diabetes, acute diabetes complications were the leading cause of admission. CVD are the leading cause of hospital admission for people with diabetes, with ischaemic or coronary heart disease as the predominant subtype.

Association between wildfire, respiratory and cardiovascular disease admission: Mediating effect of air pollutants in Korea

Association between wildfire, respiratory and cardiovascular disease admission: Mediating effect of air pollutants in Korea

Pattern of cardiovascular admission diagnoses during the month of Ramadan: a single center experience

Abstract Background Fasting Ramadan has been linked to favorable health profile, yet some unhealthy behaviors were shown to affect the progression of cardiovascular diseases during the holy month. Purpose To detect the prevalent diagnoses of cardiovascular admissions during the month of Ramadan and to compare them to the admission diagnoses during the rest of the year. Methods This retrospective observational study included all patients who were admitted to the Cardiology department and the Coronary Care Unit from April 2019 to May 2022, with 4 Ramadan months included. The median number of specific cardiac admission diagnoses during Ramadan months were compared to the median number of similar admission diagnoses during the other months of the year. Results The number of patients admitted during the 4 year-study period were 8170 patients, 14.6% of them (n = 1194 patients) were admitted during the 4 Ramadan months. All cardiovascular diagnoses were comparable during Ramadan admissions as compared to the rest of the year, Table. There was a trend towards higher cardiovascular admission rates during Ramadan in almost all diagnoses except for unstable angina, infective endocarditis and pericardial diseases. Conclusions The pattern of specific cardiovascular disease admission during Ramadan was not different from the pattern of admission during the rest of the year. Yet, there were numerically higher cardiovascular admissions during the 4 Ramadan months. Table Comparison of the median number of admission diagnoses in the 4 Ramadan months and the monthly average of the 4 years Ramadan months Median (range) Monthly average of the 4 years Median (range) P value IHD 145.5 (63) 106 (74) 0.486 * CCS 39.5 (35) 17 (11) 0.057 * ACS 107.5 (71) 89 (83) 0.686 - STEMI 49.5 (34) 39 (24) 0.343 - NSTEMI 41 (46) 39.5 (56) 1.0 - UA 8.5 (8) 10 (4) 0.686 ADHF &amp; cardiogenic shock 113.5 (111) 56 (37) 0.486 Arrhythmia 43.5 (39) 34 (10) 0.343 - AF 18.5 (22) 22.5 (5) 0.686 - SVT 9.5 (15) 6 (9) 0.486 - AFL 6 (12) 2.5 (2) 0.2 - CHB 4 (5) 3.5 (3) 0.686 IE 10.5 (7) 14 (6) 0.2 PE 3 (11) 2.5 (1) 0.686 Pericardial disease 2 (6) 6 (11) 0.2 Hypertensive urgency &amp; emergency 12 (23) 9.5 (7) 1.0 IHD, ischemic heart disease; CCS, chronic coronary syndrome; ACS, acute coronary syndrome; STEMI, ST elevation myocardial infarction; NSTEMI, non-ST elevation myocardial infarction; UA, unstable angina; ADHF, acute decompensated heart failure; AF, atrial fibrillation; SVT, supraventricular tachycardia; AFL, atrial flutter; CHD, complete heart block; IE, infective endocarditis; PE, pulmonary embolism. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.

Effects of apparent temperature on cardiovascular disease admissions in rural areas of Linxia Hui Autonomous Prefecture

Cardiovascular disease (CVD) is a major threat to public health worldwide. The relationship between CVD and temperature has been widely reported in developed countries and regions. However, there are few studies of severe CVD in poor rural areas of developing countries. Therefore, this study aimed to explore the relationship between CVD and apparent temperature (AT) in a rural area of Linxia Hui Autonomous Prefecture, China. Daily CVD admission data and meteorological data were collected from Linxia between 2014 and 2015. The media of AT was used as the reference temperature to estimate the cumulative relative risk (RR) of CVD admission. The distributed lag non-linear models were used to examine the association between AT and cumulative RR of CVD admission at lag 0–21 days. In Linxia, high AT (20 °C) had a persistent adverse effect on cumulative RR of CVD admissions, and the RR increased with increasing lag days. Cold (− 10 °C) had a protective effect on the first and later lag days (lag 0–14 and lag 0–21). Adults (aged < 65 years) and females were more susceptible to the effects of heat than males and the elderly (aged ≥ 65 years). In Linxia, China, extremely high AT is an important risk factor for CVD hospitalizations in suburban and rural populations.

Associations between air pollution and the risk of first admission and multiple readmissions for cardiovascular diseases

ObjectivesWe aimed to investigate the associations between air pollutants and the risk of admission and multiple readmission events for cardiovascular disease (CVD).MethodsA total of 285 009 participants free of CVD...

Trends and outcomes of cardiovascular disease admissions in Lagos, Nigeria: a 16-year review.

Cardiovascular disease (CVD)-related admissions are on the increase in Nigeria and the rest of Africa. This study was carried out to highlight the burden, patterns and outcomes of CVD admissions in a tertiary hospital over a 16-year period in Lagos, Nigeria. Admissions records of patients admitted into the medical wards within the study period (January 2002 to December 2017) were reviewed and relevant information pertaining to the study objectives was retrieved for analysis. There were a total of 21 369 medical admissions and 4 456 (20.8%) CVD-related admissions. A total of 3 582 medical deaths were recorded and 1 090 (30.4%) CVD-related deaths. The median age of the patients was 56.6 (46.0-68.0) years and 51.4% of these were males. Stroke, heart failure, hypertensive disease and acute coronary syndrome constituted 51.2, 36.2, 11.3 and 1.6% of all CVD admissions, respectively. There was a cumulative increase in the number of CVD admissions and deaths (p < 0.001, respectively) during the period under review. CVD admissions are not only common in Nigeria, but there was also a temporal exponential increase in both the admission and death rates, most likely reflecting the epidemiological transition in Nigeria.

Abstract P362: Length Of Stay Discrepancies Between Rural And Urban Hospitals - A Cross Sectional Analysis Of Cardiovascular Disease Health Inequity

Introduction: Rural communities have historically been shown to have greater obstacles to healthcare compared to their urban counterparts. These barriers manifest through multiple factors such as a reduced access to healthcare and public health services, lower availability of specialty care, and a larger number of uninsured. Compounded with a greater poverty rate, these disparities in minority populations have been shown to parallel their worse health outcomes and higher death rates. Our study aims to highlight cardiovascular disease health inequity between rural and urban populations through a cross-sectional analysis of the Length of Stay (LOS) with respect to cardiovascular disease admissions, specifically for unstable angina (UA), NSTEMI, and STEMI. Methods: This is a cross-sectional review for the LOS estimates in patients with cardiovascular disease in the state of New York, stratified by the type of community hospital. This review utilizes the 2020 National Inpatient Sample (NIS) for the state of New York. Cardiovascular disease was categorized using ICD-10 codes for STEMI (I21), NSTEMI (I21.4), and Unstable Angina (I20.0). Community hospital setting was categorized as either rural or urban, determined by the zip code of the primary inpatient hospital. Results: LOS was unique across both classification of cardiovascular disease ( p &lt;0.001) and community hospital setting ( p &lt;0.001). Overall, the LOS was less in urban-level community hospitals compared to their rural counterparts, 3.5 days vs 5.1 days ( p &lt;0.001), as shown in Figure 1. Stratified by the cardiovascular disease classifications, admissions in rural hospitals had an overall increased LOS, 0.8 days for UA ( p &lt;0.001), 1.4 days for NSTEMI ( p &lt;0.001), and 2.7 days for STEMI ( p &lt;0.001). Conclusion: The LOS of patients admitted for ACS was significantly higher across the board for rural hospitals. Furthermore, there was a stepwise increase in the comparative LOS between these two communities as the severity of their cardiovascular disease increased. Factors such as socioeconomic status, general access to healthcare and preventative services, insurance status, and availability of specialty care services are just some of the factors that contribute to rural health disparities.

Association of ambient particulate matter with hospital admissions, length of hospital stay, and hospital costs due to cardiovascular disease: time-series analysis based on data from the Shanghai Medical Insurance System from 2016 to 2019

BackgroundThere is limited evidence supporting a relationship of ambient particulate matter (PM), especially PM1, with hospital admissions, hospital costs, and length of hospital stay (LOS) due to cardiovascular disease (CVD). We used a generalized additive model (GAM) to estimate the associations of these indicators due to CVD for each 10 μg/m3 increase in the level of PM1, PM2.5, and PM10, and the attributable risk caused by PM on CVD was determined using the WHO air quality guidelines from 2005 and 2021.ResultsFor each 10 μg/m3 increase in the level of each PM and for a 0-day lag time, there were significant increases in daily hospital admissions for CVD (PM1: 1.006% [95% CI 0.859, 1.153]; PM2.5: 0.454% [95% CI 0.377, 0.530]; PM10: 0.263% [95% CI 0.206, 0.320]) and greater daily hospital costs for CVD (PM1: 523.135 thousand CNY [95% CI 253.111, 793.158]; PM2.5: 247.051 thousand CNY [95% CI 106.766, 387.336]; PM10: 141.284 thousand CNY [95% CI 36.195, 246.373]). There were no significant associations between PM and daily LOS. Stratified analyses demonstrated stronger effects in young people and males for daily hospital admissions, and stronger effects in the elderly and males for daily hospital costs. Daily hospital admissions increased linearly with PM concentration up to about 30 µg/m3 (PM1), 60 µg/m3 (PM2.5), and 90 µg/m3 (PM10), with slower increases at higher concentrations. Daily hospital costs had an approximately linear increase with PM concentration at all tested concentrations. In general, hospital admissions, hospital costs, and LOS due to CVD were greater for PM2.5 than PM10, and the more stringent 2021 WHO guidelines indicated greater admissions, costs, and LOS due to CVD.ConclusionsShort-term elevation of PM of different sizes was associated with an increased risk of hospital admissions and hospital costs due to CVD. The relationship with hospital admissions was strongest for men and young individuals, and the relationship with hospital costs was strongest for men and the elderly. Smaller PM is associated with greater risk.

Cost and outcomes of acute cardiovascular disease hospitalizations in a tertiary hospital in Ghana

ABSTRACT Background Cardiovascular diseases (CVDs) are on the rise in Sub-Saharan Africa. The management of these CVDs comes at an exorbitant cost to both individuals and health institutions. However, data on the economic impact of the most common CVDs in Ghana are lacking. Our objective was to describe the in-patient cost and outcomes of acute CVD admissions in a leading teaching hospital in Ghana. Methods We retrospectively reviewed hospital admissions, cost of hospitalization, length of stay, and CVD outcomes following admissions between January 2018 and December 2019. Results A total of 1975 patients with a mean age of 62.2 (±16.1) years were admitted over the study period of which 52.6% were males.The top 3 most prevalent CVDs among admitted patients were stroke(48.5%), hypertensive urgencies/emergencies(42.7%), and heart failure(29.4%). The overall case fatality rate (CFR) was 21.5% (95% CI: 19.7%−23.3%). The CFR for stroke, hypertensive urgencies/emergencies, and heart failure were 28.9%, 17.6%, and 14.1%, respectively. Median (IQR) length of stay and cost of treatment across all CVDs was 5(3–9) days and USD $195.29(137.9–288.9), respectively. The highest median cost for admission was for stroke (USD $211.19). Conclusion The average cost of CVD hospitalization is over a hundred times the daily minimum wage of the average Ghanaian. A greater emphasis on primordial and primary prevention is warranted to curtail the economic burden of CVDs in developing economies such as Ghana.