RACIAL DISPARITIES IN THE USE AND OUTCOMES OF EXTRA-CORPOREAL MEMBRANE OXYGENATION FOR HIGH-RISK PULMONARY EMBOLISM

Document Type

Conference Proceeding

Publication Date

4-2-2024

Publication Title

J Am Coll Cardiol

Abstract

Background In high-risk pulmonary embolism (PE) patients experiencing cardiogenic shock, temporary mechanical circulatory support (MCS) devices have emerged as pivotal interventions. The existence and extent of racial disparities in outcomes related to these interventions have not been well-studied. Methods We analyzed data from the 2016-2020 National Inpatient Sample database to identify hospitalizations that included ECMO support for high-risk PE patients in the United States and to compare outcomes across different racial and ethnic groups. The primary outcome was in-hospital mortality. Secondary outcomes included complications such as acute kidney injury, stroke, and hospital length of stay (LOS). Results The total cohort consisted of 510 patients hospitalized for high-risk PE requiring ECMO support, of whom 71% were of White race, 22% of Black race, and 4% of Hispanic ethnicity. After adjustment, Black patients had lower odds of in-hospital mortality (adjusted odds ratio [aOR] 0.04, 95% confidence interval [CI] 0.004-0.38) and Hispanic patients had similar odds of in-hospital mortality (aOR 0.74, 95% CI 0.05-10.89) compared to White patients. Black patients had similar odds of acute kidney injury (aOR 2.07, CI 0.49-8.70) and stroke (aOR 0.38, 95% CI 0.05-2.99) and a longer LOS (mean difference 23.53 days, 95% CI 1.80-45.25, p<0.03) compared to White patients. Hispanic patients had similar odds of acute kidney injury (aOR 3.41, CI 0.49- 23.81) and a similar LOS (mean difference -10.35 days, 95% CI -22.62 to 1.91, p=0.09) compared to White patients Conclusion In patients with high-risk PE requiring ECMO support, Black patients had lower in-hospital mortality and Hispanic patients had similar in-hospital mortality compared to White patients. Further comparative studies are needed to better understand these racial disparities and their implications on treatment strategies.

Volume

83

Issue

13

First Page

505

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