Association between socioeconomic and psychosocial factors with use of interventional and surgical treatments and outcomes in patients with myocardial infarction – Inpatient data of the largest European health care system

Omar Hahad, Lukas Hobohm, Sadeer Al-Kindi, Volker H. Schmitt, Fawad Kazemi-Asrar, Donya Gilan, Katja Petrowski, Tommaso Gori, Philipp Wild, Klaus Lieb, Andreas Daiber, Philipp Lurz, Thomas Münzel, Karsten Keller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Myocardial infarction (MI) is an important driver of both morbidity and mortality on a global scale. Elucidating social inequalities may help to identify vulnerable groups as well as treatment imbalances and guide efforts to improve care for MI. Methods: All hospitalized patient-cases with confirmed MI 2005-2020 in Germany were included in the study and stratified for socioeconomic or psychosocial factors (SPF) and the impact of SPF on treatment usage and adverse in-hospital events was analyzed. Results: Overall, 4,409,597 hospitalizations of MI patients were included; of these, 17,297 (0.4 %) were coded with SPF. These patients were more often of female sex (49.4 % vs. 36.9 %, P<0.001), older (median 77.0 [IQR: 65.0–84.0] vs. 73.0 [62.0–81.0] years, P<0.001) and revealed an aggravated cardiovascular profile. Although SPF were independently associated with increased usage of cardiac catheterization (OR 1.174 [95 %CI 1.136-1.212]) and percutaneous coronary intervention (OR 1.167 [95 %CI 1.130-1.205]), they were accompanied by higher risk for a prolonged length of in-hospital stay >7 days (OR 1.236 [95 %CI 1.198-1.276]) and >10 days (OR 1.296 [95 %CI 1.254-1.339]). While SPF were associated with increased risk for deep venous thrombosis and/or thrombophlebitis (OR 1.634 [95 %CI 1.427-1.870]), pulmonary embolism (OR 1.337 [95 %CI 1.149-1.555]), and acute renal failure (OR 1.170 [95 %CI 1.105-1.240), these SPF were inversely associated with in-hospital case-fatality (OR 0.461 [95 %CI 0.433-0.490]). Conclusions: This study demonstrates that SPF in hospitalized MI patients have significant impacts on treatments and outcomes. Fortunately, our data did not revealed an underuse of interventional treatments in MI patients with SPF.

Original languageEnglish (US)
JournalEuropean Journal of Internal Medicine
DOIs
StateAccepted/In press - 2024

Keywords

  • In-hospital events
  • Mortality
  • Myocardial infarction
  • Psychosocial stressors
  • Socioeconomic status

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint

Dive into the research topics of 'Association between socioeconomic and psychosocial factors with use of interventional and surgical treatments and outcomes in patients with myocardial infarction – Inpatient data of the largest European health care system'. Together they form a unique fingerprint.

Cite this