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National trends of malpractice-related cardiovascular mortality within the United States, 1999-2020
Hamza Ashraf1, Haider Ashfaq2, Neha Saleem Paryani3
1Departments ofCardiology.
Insights
Cardiovascular disease (CVD) malpractice deaths show sex disparities in the elderly US population. Findings highlight higher mortality in females, particularly NH Black females, and suggest targeted interventions are needed.
Area of Science:
- Cardiology
- Public Health
- Geriatrics
Background:
- Cardiovascular disease (CVD) is the leading cause of death in the USA.
- Cardiology is a high-risk specialty for malpractice claims.
- Understanding sex disparities in CVD mortality related to malpractice is crucial for the elderly population.
Purpose of the Study:
- To analyze sex disparities in cardiovascular disease (CVD) related mortality associated with malpractice among US elderly (≥65 years).
- To identify demographic and regional factors influencing these disparities.
Main Methods:
- Utilized CDC Wonder database for malpractice incidents in CVD treatment (1999-2020).
- Calculated age-adjusted mortality rates (AAMRs) per 1,000,000.
- Employed Joinpoint regression analysis to assess trends and annual percent changes (APCs), stratified by age, race/ethnicity, region, and setting.
Main Results:
- 2432 US deaths attributed to CVD malpractice from 1999-2020; AAMR of 2.7.
- Overall mortality rates declined significantly after an initial stable period (1999-2004).
- Females consistently had higher AAMRs (2.7) than males (2.6). NH Black females showed the highest AAMR (3.1), while NH Black males and NH Asian females had the lowest (2.5). Mortality was higher in the West and in both urban and rural female populations.
Conclusions:
- Significant sex disparities exist in elderly CVD malpractice mortality in the USA.
- Targeted interventions are essential to address elevated risks, especially for NH Black women, individuals in the West, males, and those in urban areas.
- Further research into the specific causes of these disparities is warranted.
Abstract:
Cardiovascular disease (CVD) stands as the leading cause of mortality in the USA, claiming a life every 33 seconds, while cardiology ranks among the top three specialties with malpractice-related claims. The authors' study aims to scrutinize sex disparities in CVD-related mortality linked with malpractice among the elderly population (≥65 years) in the USA. Data pertaining to malpractice incidents in CVD treatment spanning from 1999 to 2020 were sourced from the CDC Wonder database. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were computed. Joinpoint regression analysis was used to determine the annual percent changes (APCs) with a 95% CI, stratified across variables such as age, race/ethnicity, census region, and urban or rural settings. Over the investigated period, 2432 deaths in the US were attributed to CVD-related malpractice, with an AAMR of 2.7. Initially stable (1999-2004), mortality rates experienced a significant decline until 2020. Females consistently exhibited a higher AAMR (2.7) than males (2.6). Notably, NH Black females recorded the highest AAMR (3.1), while NH Black males and NH Asian females reported the lowest (2.5). Furthermore, NH White males demonstrated a higher AAMR (2.7) than NH Black males (2.5); conversely, NH Black females exhibited a higher AAMR (3.1) than NH White females (2.7). Mortality rates were notably elevated in the West compared to the South, with both urban and rural areas indicating higher AAMRs in females. The authors' findings underscore the necessity for targeted interventions to address the pronounced disparities, particularly among NH Black women, individuals in the West, males, and urban locales.
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