Characteristics and Gender-Related Differences of Patients Admitted to a Large Intensive Cardiac Care Unit: A
Şeyhmus Külahçıoğlu1, Rezzan Deniz Acar1, Servet İzci1
1Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey.
Insights
Older women admitted to intensive cardiac care units have higher mortality rates, despite fewer hospitalizations. Advanced heart failure poses the highest mortality risk, underscoring the need for multidisciplinary care in an aging population.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- The global population is aging, leading to increased complexity of cardiac patient care.
- Intensive cardiology care units (ICCUs) are seeing more complex cardiac cases, highlighting the need for multidisciplinary approaches.
Purpose of the Study:
- To analyze the clinical characteristics of patients in a large ICCU.
- To investigate gender-related differences in patient profiles and outcomes within the ICCU.
Main Methods:
- A retrospective, cross-sectional study of all hospitalizations in a large ICCU from January 2016 to March 2021.
- Data collected via software and transferred to Turkey's general database system (MEDULLA).
Main Results:
- Over 55,000 patients were analyzed; 29% were women, who were older on average (63.3 years vs. 59.7 years).
- Acute coronary syndrome was the leading cause for admission. Women had a higher mortality rate (7%) compared to men (4%), with advanced heart failure showing the highest death rate.
- Multiorgan failure developed in approximately 18% of patients during their ICCU stay.
Conclusions:
- Despite lower admission numbers, women in ICCUs are older and have higher mortality rates.
- Advanced heart failure is associated with the highest mortality, and multiorgan failure is a significant cause of death, especially in an aging population requiring multidisciplinary care.
Objective:
Parallel to the aging of the world population, the complexity of patients with cardiac problems has increased, especially in intensive cardiology care units, and the importance of multidisciplinary care has become more evident. The aim of this study was to analyze the clinical characteristics and gender-related differences of patients hospitalized in a large intensive cardiology care unit.
Methods:
This single-center, retrospective, cross-sectional study includes all hospitalizations in a large intensive cardiology care unit between January 2016 and March 2021. All data were obtained using data collection software and transferred to MEDULLA, Turkey's general database system.
Results:
Of the 55 737 consecutive patients included in the analysis, 16342 (29%) were women. The mean age of males was 59.71 ± 12 years, and the mean age of females was 63.3 ± 14 years (P <.001). Over a period of 5 years, the most common reason for hospitalization in the intensive cardiac care unit was acute coronary syndrome. The number of acute coronary syndrome patients who underwent coronary angiography was found to be 17 478 (31%), of which 12 878 were males and 26.3% were female. The number of patients who underwent at least 1 stent implantation was 13 952 (80% of coronary angiography procedures), and 2960 (21%) were women. The second cause of hospitalization in the intensive cardiology care unit was arrhythmias (5654 patients [10%]) followed by advanced heart failure (932 patients [1.7%]). During follow-up in the intensive cardiology care unit, the percentage of development of multiorgan failure was found to be approximately 18%. The mortality rate was 7% in women, which was higher than in men (4%). While the most common cause of death was acute coronary syndrome, the highest rate of death was found in patients with advanced heart failure. Among the patients who died, the mean age of females was higher than that of males, and the length of hospital stay was longer.
Conclusion:
Although numerically the highest death rate was observed in male acute coronary syndrome patients, the highest mortality rate was found in patients with advanced heart failure. Due to the elderly population and the increase in the number of patients requiring multidisciplinary treatment, the development of multiorgan failure in intensive cardiology care units seems to be one of the most important causes of death. Although the number of females hospitalized in the intensive cardiology care unit is lower than that of males, the mean age and mortality rate were found to be higher than males.
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