In-hospital outcomes in unhoused patients with cardiogenic shock in the United States: Insights from The National...

Area of Science:

• Cardiology
• Health Services Research
• Social Determinants of Health

Background:

• Unhoused individuals face significant healthcare access barriers.
• Limited data exists on outcomes for unhoused patients with cardiogenic shock (CS).

Purpose of the Study:

• To compare in-hospital outcomes and resource utilization for unhoused versus housed patients hospitalized with CS.
• To identify disparities in care for unhoused patients experiencing CS.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database (2011-2019).
• Identified unhoused patients with CS using ICD-9/ICD-10 codes.
• Compared baseline characteristics and in-hospital outcomes using logistic regression.

Main Results:

• No significant difference in mortality between unhoused and housed CS patients after adjusting for comorbidities.
• Unhoused patients had lower odds of receiving mechanical circulatory support, cardiac catheterization, and pulmonary artery catheterization.
• Unhoused patients experienced higher adjusted odds of infectious complications, intubation, and restraints.

Conclusions:

• Despite similar mortality, unhoused CS patients receive less aggressive, potentially more conservative, care.
• Higher intubation rates in unhoused patients may indicate under-diuresis or conservative management.
• Further research is needed to address care barriers for unhoused populations.