Tags

Type your tag names separated by a space and hit enter

Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States.
BMC Health Serv Res. 2018 05 16; 18(1):370.BH

Abstract

BACKGROUND

Acute myocardial infarction (AMI) is a common high-risk disease with inpatient mortality of 5% nationally. But little is known about this outcome among Asian Americans (Asians), a fast growing racial/ethnic minority in the country. The objectives of the study are to obtain near-national estimates of differences in AMI inpatient mortality between minorities (including Asians) and non-Hispanic Whites and identify comorbidities and sociodemographic characteristics associated with these differences.

METHOD

This is a retrospective analysis of 2010-2011 state inpatient discharge data from 10 states with the largest share of Asian population. We identified hospitalization with a primary diagnosis of AMI using the ICD-9 code and used self-reported race/ethnicity to identify White, Black, Hispanic, and Asian. We performed descriptive analysis of sociodemographic characteristics, medical comorbidities, type of AMI, and receipt of cardiac procedures. Next, we examined overall inpatient AMI mortality rate based on patients' race/ethnicity. We also examined the types of AMI and a receipt of invasive cardiac procedures by race/ethnicity. Lastly, we used sequential multivariate logistic regression models to study inpatient mortality for each minority group compared to Whites, adjusting for covariates.

RESULTS

Over 70% of the national Asian population resides in the 10 states. There were 496,472 hospitalizations with a primary diagnosis of AMI; 75% of all cases were Whites, 10% were Blacks, 12% were Hispanics, and 3% were Asians. Asians had a higher prevalence of cardiac comorbidities, including hypertension, diabetes, and kidney failure compared to Whites (p-value< 0.01). There were 158,623 STEMI (ST-elevation AMI), and the proportion of hospitalizations for STEMI was the highest for Asians (35.2% for Asians, 32.7% for Whites, 25.3% for Blacks, and 32.1% for Hispanics). Asians had the highest rates of inpatient AMI mortality: 7.2% for Asians, 6.3% for Whites, 5.4% for Blacks, and 5.9% for Hispanics (ANOVA p-value < 0.01). In adjusted analyses, Asians (OR = 1.11 [95% CI: 1.04-1.19]) and Hispanics (OR = 1.14 [1.09-1.19]) had a higher likelihood of inpatient mortality compared to Whites.

CONCLUSIONS

Asians had a higher risk-adjusted likelihood of inpatient AMI mortality compared to Whites. Further research is needed to identify the underlying reasons for this finding to improve AMI disparities for Asians.

Authors+Show Affiliations

General Internal Medicine, Zucker School of Medicine at Hofstra/Northwell, 2001 Marcus Avenue Suite S160, Lake Success, NY, 11042, USA. ekim7@northwell.edu.General Internal Medicine, Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Two, Boston, MA, 02118, USA. VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA.General Internal Medicine, Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Two, Boston, MA, 02118, USA.University of California San Francisco School of Medicine, 4150 Clement Street, San Francisco, CA, 94121, USA.MedStar Washington Hospital Center, 106 Irving Street NW POB South 124, Washington, DC, 20010, USA.General Internal Medicine, Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Two, Boston, MA, 02118, USA.General Internal Medicine, Boston University School of Medicine, 801 Massachusetts Avenue, Crosstown Two, Boston, MA, 02118, USA. VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29769083

Citation

Kim, Eun Ji, et al. "Racial/ethnic Disparities Among Asian Americans in Inpatient Acute Myocardial Infarction Mortality in the United States." BMC Health Services Research, vol. 18, no. 1, 2018, p. 370.
Kim EJ, Kressin NR, Paasche-Orlow MK, et al. Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States. BMC Health Serv Res. 2018;18(1):370.
Kim, E. J., Kressin, N. R., Paasche-Orlow, M. K., Lopez, L., Rosen, J. E., Lin, M., & Hanchate, A. D. (2018). Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States. BMC Health Services Research, 18(1), 370. https://doi.org/10.1186/s12913-018-3180-0
Kim EJ, et al. Racial/ethnic Disparities Among Asian Americans in Inpatient Acute Myocardial Infarction Mortality in the United States. BMC Health Serv Res. 2018 05 16;18(1):370. PubMed PMID: 29769083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/ethnic disparities among Asian Americans in inpatient acute myocardial infarction mortality in the United States. AU - Kim,Eun Ji, AU - Kressin,Nancy R, AU - Paasche-Orlow,Michael K, AU - Lopez,Lenny, AU - Rosen,Jennifer E, AU - Lin,Mengyun, AU - Hanchate,Amresh D, Y1 - 2018/05/16/ PY - 2017/08/29/received PY - 2018/05/02/accepted PY - 2018/5/18/entrez PY - 2018/5/18/pubmed PY - 2018/11/27/medline KW - Acute myocardial infarction KW - Asian KW - Health disparity KW - Mortality, comorbidities SP - 370 EP - 370 JF - BMC health services research JO - BMC Health Serv Res VL - 18 IS - 1 N2 - BACKGROUND: Acute myocardial infarction (AMI) is a common high-risk disease with inpatient mortality of 5% nationally. But little is known about this outcome among Asian Americans (Asians), a fast growing racial/ethnic minority in the country. The objectives of the study are to obtain near-national estimates of differences in AMI inpatient mortality between minorities (including Asians) and non-Hispanic Whites and identify comorbidities and sociodemographic characteristics associated with these differences. METHOD: This is a retrospective analysis of 2010-2011 state inpatient discharge data from 10 states with the largest share of Asian population. We identified hospitalization with a primary diagnosis of AMI using the ICD-9 code and used self-reported race/ethnicity to identify White, Black, Hispanic, and Asian. We performed descriptive analysis of sociodemographic characteristics, medical comorbidities, type of AMI, and receipt of cardiac procedures. Next, we examined overall inpatient AMI mortality rate based on patients' race/ethnicity. We also examined the types of AMI and a receipt of invasive cardiac procedures by race/ethnicity. Lastly, we used sequential multivariate logistic regression models to study inpatient mortality for each minority group compared to Whites, adjusting for covariates. RESULTS: Over 70% of the national Asian population resides in the 10 states. There were 496,472 hospitalizations with a primary diagnosis of AMI; 75% of all cases were Whites, 10% were Blacks, 12% were Hispanics, and 3% were Asians. Asians had a higher prevalence of cardiac comorbidities, including hypertension, diabetes, and kidney failure compared to Whites (p-value< 0.01). There were 158,623 STEMI (ST-elevation AMI), and the proportion of hospitalizations for STEMI was the highest for Asians (35.2% for Asians, 32.7% for Whites, 25.3% for Blacks, and 32.1% for Hispanics). Asians had the highest rates of inpatient AMI mortality: 7.2% for Asians, 6.3% for Whites, 5.4% for Blacks, and 5.9% for Hispanics (ANOVA p-value < 0.01). In adjusted analyses, Asians (OR = 1.11 [95% CI: 1.04-1.19]) and Hispanics (OR = 1.14 [1.09-1.19]) had a higher likelihood of inpatient mortality compared to Whites. CONCLUSIONS: Asians had a higher risk-adjusted likelihood of inpatient AMI mortality compared to Whites. Further research is needed to identify the underlying reasons for this finding to improve AMI disparities for Asians. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/29769083/Racial/ethnic_disparities_among_Asian_Americans_in_inpatient_acute_myocardial_infarction_mortality_in_the_United_States_ L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3180-0 DB - PRIME DP - Unbound Medicine ER -