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Race and sex differences in the refusal of cardiac catheterization among elderly patients hospitalized with acute myocardial infarction.
- Source :
-
American heart journal [Am Heart J] 2002 Dec; Vol. 144 (6), pp. 1052-6. - Publication Year :
- 2002
-
Abstract
- Background: Prior studies have reported race and sex differences in cardiac catheterization use after acute myocardial infarction (AMI). It is unclear whether race or sex differences in procedure refusal may contribute to this difference. We sought to determine whether cardiac catheterization refusal rates differ by patient race or sex.<br />Methods: We evaluated medical records of 74,745 Medicare beneficiaries hospitalized for AMI between January 1994 and February 1996 to ascertain refusal of cardiac catheterization during hospitalization. Patient race and sex were evaluated for their association with cardiac catheterization refusal adjusting for patient, physician, and hospital characteristics.<br />Results: The cardiac catheterization refusal rate in the overall cohort was 2.92% (95% CI 2.80%-3.04%). Race and sex differences in cardiac catheterization were observed after multivariate adjustment, with white women (odds ratio [OR] 1.28), black men (OR 1.34), and black women (OR 1.37) more likely to refuse cardiac catheterization than white men (OR 1.00). Relative differences in refusal were associated with only modest absolute differences in risk-standardized rates of cardiac catheterization refusal; rates were lowest for white men (2.55%), and higher for white women (3.21%), black men (3.36%), and black women (3.38%, P <.001 for global comparison).<br />Conclusions: Patient race and sex were associated with cardiac catheterization refusal among elderly patients hospitalized with AMI. However, absolute race and sex differences in rates of procedure refusal were small, suggesting that race and sex differences in cardiac catheterization refusal provide only a partial explanation of observed differences in cardiac procedure use.
- Subjects :
- Aged
Female
Hospitalization
Humans
Logistic Models
Male
Myocardial Infarction ethnology
Sex Factors
Socioeconomic Factors
Treatment Refusal ethnology
United States epidemiology
Black or African American statistics & numerical data
Cardiac Catheterization statistics & numerical data
Myocardial Infarction epidemiology
Myocardial Infarction therapy
Treatment Refusal statistics & numerical data
White People statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6744
- Volume :
- 144
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 12486430
- Full Text :
- https://doi.org/10.1067/mhj.2002.126122