Gender Differences in Takotsubo Cardiomyopathy as a Secondary Diagnosis: Higher Hospital Charges, More Procedures, and Longer Length of StaysThe American College of Cardiology 68th Annual Scientific Sessions (2019)
The incidence of Takotsubo Cardiomyopathy (TC) has risen steadily over the past decade, with current estimates of 15-30 cases per 100,000 per year. Historically, men diagnosed with TC have worse outcomes compared to women. The relationship between total hospital charges, number of procedures performed, and length of stay (LOS) between genders has not been previously reported with TC as a secondary diagnosis.
National Inpatient Sample (NIS) data from 2009-2015 was used to identify encounters of adult patients (≥18 years) undergoing coronary angiography that were ultimately given a secondary diagnosis of TC (International Classification of Diseases – 9 code 429.83). Demographics, comorbidities and outcomes including hospital mortality, total charges, and LOS were assessed and stratified by gender. Continuous variables were described using means and compared using independent two-sample t-tests. Total charges and LOS were described using medians and compared using Wilcoxon rank sum test. TC encounters were propensity matched by age, number of chronic conditions, number of procedures performed, and severity of illness. A discharge weight was included in all analyses to account for the complex sample design of the NIS.
During 2009-2015, 1,448 men and 9,404 women with secondary TC were identified in the dataset, corresponding to a national estimate of 7,124 men and 46,163 women. The median hospital charges were $54,655 for men and $45,455 for women (p<.05). Average procedures performed was 5.2 for men and 4.5 for women (p<.05). Median LOS was 4.3 days for men and 3.6 days for women (p<.05). In-hospital mortality was 5.5% in men and 3.3% in women (p<.05). Applying propensity-matching for age and number of procedures, the difference between men and women for median total charges decreased to $1,658, the LOS difference decreased to 0.3 days, and the mortality difference decreased to 1.3%.
Compared to women, men with a secondary diagnosis of TC are more likely to have a greater number of procedures, leading to a longer LOS and ∼$10,000 more in hospital charges. Greater awareness of TC as a potential secondary diagnosis is warranted among men.
Poster Contributions Poster Hall, Hall F Sunday, March
Publication DateMarch, 2019
LocationNew Orleans, LA, United States
Citation InformationDaniel Eric Westerdahl, Hsin-Fang Li, Amir Yazdani, Kateri Spinelli, et al.. "Gender Differences in Takotsubo Cardiomyopathy as a Secondary Diagnosis: Higher Hospital Charges, More Procedures, and Longer Length of Stays" The American College of Cardiology 68th Annual Scientific Sessions Vol. 73 Iss. 9 (2019) p. 890
Available at: http://works.bepress.com/hsin-fang-li/21/