Gender Differences in Takotsubo Cardiomyopathy as a Secondary Diagnosis: Higher Hospital Charges, More Procedures, and Longer Length of Stays

Publication Title

Journal of the American College of Cardiology

Authors

Daniel Westerdahl, Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence St Joseph Health, Portland, ORFollow
Hsin-Fang Li, Providence St Vincent Medical CenterFollow
Amir Yazdani, Providence St. Joseph Health, CARDSFollow
Kateri Spinelli, Providence St. Joseph Health, CARDSFollow
Tyler J Gluckman, Providence Heart and Vascular Institute, Portland, OR, USA.Follow

Document Type

Abstract

Publication Date

3-4-2019

Keywords

cards

Abstract

Background

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.

Methods

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.

Results

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

Conclusion

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.

Area of Special Interest

Cardiovascular (Heart)

Specialty/Research Institute

Cardiology

Specialty/Research Institute

Center for Cardiovascular Analytics, Research + Data Science (CARDS)