Abstract 12581: Sex Differences in 30-day All-cause Mortality Following Hospitalization for Acute Myocardial Infarction

Introduction:Sex differences in comorbidities and care received during hospitalization for acute myocardial infarction (AMI) may lead to disparities in short-term outcomes following discharge. We examined the association between sex and 30-day all-cause mortality among adults hospitalized with AMI in a diverse, integrated healthcare delivery system.Methods:We identified 44,142 Kaiser Permanente Southern California members (aged >35 years) with a primary discharge diagnosis of AMI between 2000 and 2014. Incident AMI hospitalization was defined as the first AMI event identified in the electronic health record between 2000 and 2014, with no prior AMI hospitalizations. Death was ascertained from administrative sources, state death data, and Social Security Administration files. We compared characteristics of women and men hospitalized for AMI and estimate relative risks (RR) and 95% confidence intervals (CI) for the association between sex and 30-day all-cause mortality.Results:Women were older and more likely to be black, more likely to have hypertension and chronic obstructive pulmonary disease, and less likely to receive coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) during AMI hospitalization compared to men. (Table) Overall, 12.0% of women and 8.9% of men died within 30 days of discharge. After adjustment for age, race, and year of hospitalization women compared to men had an increased likelihood of 30-day mortality (RR 1.08, 95% CI 1.02, 1.14). The addition of comorbidities and AMI type did not change this association (RR 1.09, 95% CI 1.03, 1.15). After additional adjustment for CABG and PCI, men and women had an equal likelihood of 30-day mortality (RR 1.04, 95% CI 0.98, 1.10).Conclusion:Women compared to men had a higher likelihood of 30-day mortality independent of sociodemographic and clinical characteristics. This disparity may be attributable to differences in in-hospital care.