Rural/urban disparities in the trends and outcomes of peripartum cardiomyopathy in delivery hospitalizations
Copyright © 2024 Elsevier Inc. All rights reserved..
BACKGROUND: Rural-urban disparities in peripartum cardiomyopathy (PPCM) are not well known. We examined rural-urban differences in maternal, fetal, and cardiovascular outcomes in PPCM during delivery hospitalizations.
METHODS: We used 2003-2020 data from the National Inpatient Sample for delivery hospitalizations in individuals with PPCM. The 9th and 10th editions of the International Classification of Diseases were used to identify PPCM and cardiovascular, maternal, and fetal outcomes. Rural and urban hospitalizations for PPCM were 1:1 propensity score-matched using relevant clinical and sociodemographic variables. Odds of in-hospital mortality were assessed using logistic regression.
RESULTS: Among 72,880 delivery hospitalizations with PPCM, 4,571 occurred in rural locations, while 68,309 occurred in urban locations. After propensity matching, there were a total of 4,571 rural-urban pairs. There was significantly higher in-hospital mortality in urban compared to rural hospitalizations (adjusted OR 1.54, 95% CI 1.10-1.89). Urban PPCM hospitalizations had significantly higher cardiogenic shock (2.9% vs. 1.3%), mechanical circulatory support (1.0% vs. 0.6%), cardiac arrest (2.3% vs. 0.9%), and VT/VF (4.5% vs. 2.1%, all p <.05). Additionally, urban PPCM hospitalizations had worse maternal and fetal outcomes as compared to rural hospitalizations, including higher preterm delivery, gestational diabetes, and fetal death (all p<.05). Notably, significantly more rural individuals were transferred to a short-term hospital (including tertiary care centers) compared to urban individuals (13.5% vs. 3.2%, p<.0001).
CONCLUSIONS: There are significant rural-urban disparities in delivery hospitalizations with PPCM. Worse outcomes were associated with urban hospitalizations, while rural PPCM hospitalizations were associated with increased transfers, suggesting inadequate resources and advanced sickness.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
|---|---|
| Enthalten in: |
Current problems in cardiology - 49(2024), 4 vom: 31. März, Seite 102433 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shah, Lochan M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 04.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.cpcardiol.2024.102433 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367912775 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367912775 | ||
| 003 | DE-627 | ||
| 005 | 20240304232410.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240202s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.cpcardiol.2024.102433 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1316.xml |
| 035 | |a (DE-627)NLM367912775 | ||
| 035 | |a (NLM)38301915 | ||
| 035 | |a (PII)S0146-2806(24)00072-0 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shah, Lochan M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rural/urban disparities in the trends and outcomes of peripartum cardiomyopathy in delivery hospitalizations |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.03.2024 | ||
| 500 | |a Date Revised 04.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Rural-urban disparities in peripartum cardiomyopathy (PPCM) are not well known. We examined rural-urban differences in maternal, fetal, and cardiovascular outcomes in PPCM during delivery hospitalizations | ||
| 520 | |a METHODS: We used 2003-2020 data from the National Inpatient Sample for delivery hospitalizations in individuals with PPCM. The 9th and 10th editions of the International Classification of Diseases were used to identify PPCM and cardiovascular, maternal, and fetal outcomes. Rural and urban hospitalizations for PPCM were 1:1 propensity score-matched using relevant clinical and sociodemographic variables. Odds of in-hospital mortality were assessed using logistic regression | ||
| 520 | |a RESULTS: Among 72,880 delivery hospitalizations with PPCM, 4,571 occurred in rural locations, while 68,309 occurred in urban locations. After propensity matching, there were a total of 4,571 rural-urban pairs. There was significantly higher in-hospital mortality in urban compared to rural hospitalizations (adjusted OR 1.54, 95% CI 1.10-1.89). Urban PPCM hospitalizations had significantly higher cardiogenic shock (2.9% vs. 1.3%), mechanical circulatory support (1.0% vs. 0.6%), cardiac arrest (2.3% vs. 0.9%), and VT/VF (4.5% vs. 2.1%, all p <.05). Additionally, urban PPCM hospitalizations had worse maternal and fetal outcomes as compared to rural hospitalizations, including higher preterm delivery, gestational diabetes, and fetal death (all p<.05). Notably, significantly more rural individuals were transferred to a short-term hospital (including tertiary care centers) compared to urban individuals (13.5% vs. 3.2%, p<.0001) | ||
| 520 | |a CONCLUSIONS: There are significant rural-urban disparities in delivery hospitalizations with PPCM. Worse outcomes were associated with urban hospitalizations, while rural PPCM hospitalizations were associated with increased transfers, suggesting inadequate resources and advanced sickness | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Patel, Harsh |e verfasserin |4 aut | |
| 700 | 1 | |a Faisaluddin, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Kwapong, Yaa A |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Bhavin A |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Eunjung |e verfasserin |4 aut | |
| 700 | 1 | |a Satti, Danish Iltaf |e verfasserin |4 aut | |
| 700 | 1 | |a Oyeka, Chigolum P |e verfasserin |4 aut | |
| 700 | 1 | |a Hegde, Shruti |e verfasserin |4 aut | |
| 700 | 1 | |a Dani, Sourbha S |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Garima |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Current problems in cardiology |d 1993 |g 49(2024), 4 vom: 31. März, Seite 102433 |w (DE-627)NLM000219622 |x 1535-6280 |7 nnns |
| 773 | 1 | 8 | |g volume:49 |g year:2024 |g number:4 |g day:31 |g month:03 |g pages:102433 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.cpcardiol.2024.102433 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 49 |j 2024 |e 4 |b 31 |c 03 |h 102433 | ||