Racial and ethnic differences in diagnosis, healthcare utilization and 1-year outcomes for patients with significant...

Background: The impact of race and ethnicity on prognosis and clinical outcomes in patients with significant tricuspid regurgitation (sTR) is not well understood. Aim: Describe healthcare utilization trends preceding the development of sTR and assess clinical outcomes 1-year post-sTR status by race and ethnicity. Materials & methods: We conducted a retrospective, longitudinal descriptive study using data from a large database containing electronic health record and insurance claims information. We employed multivariate modeling to assess the relationship between 1-year clinical outcomes and mutually exclusive race/ethnicity groups and other baseline factors. Results: Black patients were more likely to be identified as having sTR as inpatients when compared with White patients (p < 0.001) and had fewer outpatient visits to cardiac specialists before and after developing sTR (p < 0.01). Black and Hispanic patients with sTR were at increased risk of heart failure hospitalization compared with White patients at 1 year (adjusted HR: 1.21, 95% CI: 1.16-1.26, p < 0.001 and adjusted HR: 1.10, 95% CI: 1.02-1.19, p < 0.05 respectively). However, both Black and Hispanic patients had lower 1-year mortality than White patients in the adjusted model. Conclusion: Black and Hispanic patients are less likely to have received outpatient care by a cardiac specialist prior to the development of sTR, and have higher rates of heart failure hospitalization after diagnosis. In contrast, their mortality rates following sTR identification are lower than White patients. Further investigation into the underlying mechanisms of these observations is needed to improve TR-related outcomes.