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Health services research
Research
Gender disparities among hospitalised patients with acute myocardial infarction, acute decompensated heart failure or pneumonia: retrospective cohort study
  1. Mouaz Alsawas1,2,
  2. Zhen Wang1,2,
  3. M Hassan Murad1,2,
  4. Mohammed Yousufuddin3
  1. 1 Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Mayo Clinic Robert D and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
  3. 3 Department of Hospital Internal Medicine, Mayo Clinic Health System, Austin, Minnesota, USA
  1. Correspondence to Dr Mouaz Alsawas; Alsawas.mouaz{at}mayo.edu

Abstract

Objective To assess gender disparity in outcomes among hospitalised patients with acute myocardial infarction (AMI), acute decompensated heart failure (ADHF) or pneumonia.

Design A retrospective cohort study.

Setting A tertiary referral centre in Midwest, USA.

Participants We evaluated 12 265 adult patients hospitalised with ADHF, 15 777 with AMI and 12 929 with pneumonia, from 1 January 1995 through 31 August 2015. Patients were selected using International Classification of Diseases, Ninth Revision, Clinical Modification codes.

Primary and secondary outcome measures Prevalence of comorbidities, 30-day mortality and 30-day readmission. Comorbidities were chosen from the 20 chronic conditions, specified by the Office of the Assistant Secretary for Health. Logistic regression analysis was conducted adjusting for multiple confounders.

Results Prevalence of comorbidities was significantly different between men and women in all three conditions. After adjusting for age, length of stay, multicomorbidities and residence, there was no significant difference in 30-day mortality between men and women in AMI or ADHF, but men with pneumonia had slightly higher 30-day mortality with an OR of 1.19 (95% CI 1.06 to 1.34). There was no significant difference in 30-day readmission between men and women with AMI or pneumonia, but women with ADHF were slightly more likely to be readmitted within 30 days with OR 0.90 (95% CI 0.82 to 0.99).

Conclusion Gender differences in the distribution of comorbidities exist in patients hospitalised with AMI, ADHF and pneumonia. However, there is minimal clinically meaningful impact of these differences on outcomes. Efforts to address gender difference may need to be diverted towards targeting overall population health, reducing race/ethnicity disparity and improving access to care.

  • internal medicine
  • cardiology
  • respiratory infections

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022782

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    Footnotes

    • Patient consent for publication Not required.

    • Contributors MA: conception and design of the study, data collection, data analysis, interpreted results, drafted and revised manuscript; ZW: data analysis, manuscript revision and approval of final draft; MHM: contributed to study design, manuscript development and approval of final draft; MY: developed the idea for the study, interpreted results, revised manuscript and approval of final draft.

    • Funding This publication was made possible by CTSA grant number UL1 TR000135 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health (NIH).

    • Disclaimer Contents of the article are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

    • Competing interests None declared.

    • Ethics approval Mayo Clinic Institutional Review Committee (IRB).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.