Background: The impact of race and its related social determinants of health on cardiovascular disease outcomes has been well documented. However, limited data exist regarding the association of race with in-hospital outcomes in patients admitted for sinus node dysfunction (SND).
Objective: To evaluate whether racial disparities exist in outcomes for patients hospitalized with a primary diagnosis of SND.
Methods: The National Inpatient Sample was queried from 2011 to 2018 for relevant ICD-9 and ICD-10 diagnosis and procedure codes. Baseline characteristics and in-hospital outcomes in patients with a primary diagnosis of SND were compared among White and non-White patients. A multivariate logistic regression model was used to adjust for potential confounding factors and statistically significant comorbidities between both cohorts.
Results: We identified 655,139 persons admitted with a primary diagnosis of SND, 520,926 (79.5%) of whom were White. Non-White patients had significantly higher all-cause mortality, length of stay, and total hospital cost. There were lower odds of pacemaker insertion (adjusted odds ratio [aOR] 1.13 [95% confidence interval (CI) 1.11-1.15]), temporary transvenous pacing (aOR 1.15 [95% CI 1.11-1.22]), and cardioversion (aOR 1.50 [95% CI 1.42-1.58]) in non-White patients. A subgroup analysis was performed and non-Hispanic Black race was predictive of a decreased odds of pacemaker insertion, cardioversion/defibrillation, and temporary transvenous pacing.
Conclusion: Significant differences of in-hospital outcomes exist between White and non-White patients with SND. These findings appeared to be primarily driven by disparities in non-Hispanic Black patients. Increased recognition and focused efforts to mitigate these disparities will improve the care of underrepresented populations treated for SND.
Keywords: Arrhythmia; Cardioversion; Defibrillation; Pacemaker; Racial disparities; Sick sinus syndrome; Sinus node dysfunction.
© 2022 Heart Rhythm Society. Published by Elsevier Inc.