在多站点队列中,胸痛患者的心脏检测率的种族差异
Lucas M Popp1, Nicklaus P Ashburn1,2, Anna C Snavely1,3
1Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
概括
在急诊室存在种族差异. 非白人患者接受的非侵入性检测和心脏导管治疗较少,但对复血管和心脏死亡或心肌梗塞的结果相似.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 种族医疗保健差异是一个重大的公共卫生问题.
- 关于急诊室 (ED) 胸部疼痛管理中的基于种族的差异存在有限的数据.
- 解决这些差异对于改善患者治疗结果至关重要.
研究的目的:
- 评估在使用诊断和治疗程序的种族差异,为患者呈现胸痛在ED.
- 评估种族和30天不良心脏事件之间的关联,包括心肌梗塞 (MI) 和心脏死亡.
主要方法:
- 为优化胸痛风险分层 (STOP-CP) 的高灵敏性心脏热素T队伍 (2017-2018) 的二次分析.
- 包括1454名患有急性冠状动脉综合征症状但没有ST升高的成年患者,来自8个美国ED.
- 后勤回归分析以确定比赛和30天结果之间的关联,调整混因素.
主要成果:
- 与白人患者相比,非白人患者 (42.3%) 接受30天非侵入性检测 (NIT) (OR 0.76,aOR 0.71) 和心脏导管 (OR 0.62,aOR 0.62) 的可能性较低.
- 复血管化率 (OR 0.67,aOR 0.74) 和30天心脏病死亡或MI (OR 0.79,aOR 0.74) 在同变量调整后的种族群体之间是相似的.
- 在非白人种族与接受NIT和心脏导管治疗的几率下降之间发现了显著的关联.
结论:
- 与白人患者相比,这个美国队列中的非白人患者在接受关键心脏诊断程序 (NIT,导管) 方面存在差异.
- 尽管初始测试的差异,30天的复血管化率和主要的不良心脏事件在种族群体之间是可比的.
- 需要进一步的研究来理解和减轻紧急心脏护理中的这些差异.
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