National Trends In Racial Disparities Among Hospitalizations And Outcomes In Patients With Dilated Cardiomyopathy

Background Dilated cardiomyopathy (DCM) is usually progressive, leading to a decline in ventricular function, followed by conduction system abnormalities, ventricular arrhythmias, thromboembolism, renal failure, depression, and progression to chronic heart failure. Our study aimed to decipher the recent trends in hospitalization and in-hospital mortality attributable to dilated cardiomyopathy in the United States. Methods We conducted our analysis using data from the Nationwide Inpatient Sample (NIS) from 2016 to 2020. We obtained data from patients aged ≥18 years with diagnosis of DCM. Diagnoses and comorbidities were identified using codes from the International Classification of Disease 10th edition. We used the chi-square test to compare baseline characteristics in the population with DCM. Our primary outcome of interest was in hospital-mortality. The secondary outcome was in-hospital cardiovascular events. Results We studied a total of 203,187 hospitalizations of patients with DCM. The annual number of hospitalizations increased from 2016 to 2020 (31,078 - 43,585). Commonest age groups involved were 65 to 74 years (23.82%). When stratified by race, white males were hospitalized more frequently than white females, whereas more black females were hospitalized than their male counterparts. Whites had the highest average in-hospital mortality (61.17%) (see table 1). However, within the black population, the trend in annual mortality rate was higher compared to whites during the study period. Average hospitalization-related cost increased significantly ($41,851.00 - $53,941.5) (p<0.0001); however, median length of hospital stay remained similar (4-5 days). Except for acute myocardial infarction, there was generally an upward trend in in-hospital cardiovascular events and comorbidities (see table 2). Conclusion The proportion of patients with significant comorbidities and in-hospital events increased during the study period. This suggests a continual rise in the health-care burden of dilated cardiomyopathy amidst racial disparities. There remains a need for interventions to curb these outcomes. Dilated cardiomyopathy (DCM) is usually progressive, leading to a decline in ventricular function, followed by conduction system abnormalities, ventricular arrhythmias, thromboembolism, renal failure, depression, and progression to chronic heart failure. Our study aimed to decipher the recent trends in hospitalization and in-hospital mortality attributable to dilated cardiomyopathy in the United States. We conducted our analysis using data from the Nationwide Inpatient Sample (NIS) from 2016 to 2020. We obtained data from patients aged ≥18 years with diagnosis of DCM. Diagnoses and comorbidities were identified using codes from the International Classification of Disease 10th edition. We used the chi-square test to compare baseline characteristics in the population with DCM. Our primary outcome of interest was in hospital-mortality. The secondary outcome was in-hospital cardiovascular events. We studied a total of 203,187 hospitalizations of patients with DCM. The annual number of hospitalizations increased from 2016 to 2020 (31,078 - 43,585). Commonest age groups involved were 65 to 74 years (23.82%). When stratified by race, white males were hospitalized more frequently than white females, whereas more black females were hospitalized than their male counterparts. Whites had the highest average in-hospital mortality (61.17%) (see table 1). However, within the black population, the trend in annual mortality rate was higher compared to whites during the study period. Average hospitalization-related cost increased significantly ($41,851.00 - $53,941.5) (p<0.0001); however, median length of hospital stay remained similar (4-5 days). Except for acute myocardial infarction, there was generally an upward trend in in-hospital cardiovascular events and comorbidities (see table 2). The proportion of patients with significant comorbidities and in-hospital events increased during the study period. This suggests a continual rise in the health-care burden of dilated cardiomyopathy amidst racial disparities. There remains a need for interventions to curb these outcomes.