Looking At Racial Differences In Older Patients Hospitalized For Heart Attacks

Very few people are average, that is the problem with using population level statistics in a clinical environment, and why few do it.Yet a population can show what questions to ask, like if there are racial differences in outcomes and why. A recent analysis in the Journal of the American Geriatrics Society included data on 2,918 patients aged 75 years or older who were hospitalized for heart attacks at 94 US hospitals from 2013–2016.

Very few people are average, that is the problem with using population level statistics in a clinical environment, and why few do it.

Yet a population can show what questions to ask, like if there are racial differences in outcomes and why. A recent analysis in the Journal of the American Geriatrics Society included data on 2,918 patients aged 75 years or older who were hospitalized for heart attacks at 94 US hospitals from 2013–2016.

Black participants had 2-fold higher odds of dying within 6 months, but this elevated risk was no longer significant after adjusting for age, clinical characteristics, and functional/geriatric conditions. Black participants were more likely than white participants to have impairments in cognition (37.6% versus 14.5%), mobility (66.0% versus 54.6%) and vision (50.1% versus 35.7%) at the time of admission to the hospital. Black participants were also more likely to report a disability in one or more activities of daily living (22.4% versus 13.0%) and an unintentional loss of more than 10 lbs in the year prior to hospitalization (37.2% versus 13.0%). 

This is all just statistics, so in the exploratory pile, but it allows the medical community to search for reasons how to improve outcomes. Do black patients trust doctors less so they don't get care until the situation is more serious, did they have less access to health care in the past so they are paying the cost now? Population level answers won't apply to many individuals but doctors and nurses will certainly want to know how it can improve.

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