Abstract 10131: Alarmingly Rising Burden of Cardiovascular Comorbidities and Risk of Major Adverse Cardiac and Cerebrovascular Events in Nationwide Admissions from Low Income Households (2017 vs. 2007)

Abstract

Background: Social determinants of health have an important influence on health equity. Addressing them appropriately is essential to improve population health outcomes and decrease health care disparities. We aimed to compare data from two nationwide cohorts from the US to analyze the shift of cardiovascular risk burden and major adverse cardiac and cerebrovascular events (MACCE) in low-household income (LHI) groups. Methods: Adult admissions among patients from LHI (0-25th) quartile were identified from two cohorts in 2007 and 2017 using the National Inpatient Sample. Socio-demographics, and pre-existing cardiovascular/extra-cardiovascular comorbidities were compared between the cohorts and multivariable regression was performed to assess the risk of MACCE (all-cause mortality, acute myocardial infarction and cardiac arrest including ventricular tachyarrhythmias) in 2017 vs. 2007 cohort. Results: Hospitalizations among LHI quartile showed 12% relative increase in 2017 (N=10,680,030) as compared to 2007(N=9,510,877). The 2017 cohort was younger (mean age 57 to 54 years) and admissions among male patients increased from 39% to 43.6% between 2007 and 2017. Also, non-elective and Medicaid admissions increased from 74% to 81% and 21% to 32%, respectively in 2017. Traditional CVD risk factors and comorbidities in the LHI quartile increased in 2017 compared to 2007 cohort (Table 1). The risk of composite MACCE was higher in the 2017 cohort compared to 2007 cohort (7.2% vs 6.7%, adjusted OR 1.03, 95%CI:1.03-1.04, p<0.001). Although the hospital stay was comparable (3 days), hospitalization charges increased in 2017. Conclusion: Comparative analysis of LHI admissions across a decade shows that increasingly younger, male, non-white patients get hospitalized for non-elective reasons and have a higher burden of CVD risk factors and MACCE in 2017 vs. 2007. This warrants preventive strides to curtail CVD burden in patients of the LHI and improve health outcomes.