Abstract 16804: Nationalwide Trends and Predictors of Cardiogenic Shock in Takotsubo-Syndrome Related Admissions Stratified by Sex and Race: 2016-2019

Background: Sex and race disparities have been understudied in Takotsubo-Syndrome (TTS) patients with cardiogenic shock. The objective is to examine the recent trends and predictive factors associated with cardiogenic shock (CS) in patients with TTS, stratified by sex and race.

Methods: We analyzed the admissions related to TTS from the National Inpatient Sample (NIS) 2016-2019 using the ICD-10-CM codes to examine the nationwide trends and predictors of cardiogenic shock taking into consideration the factors of sex and race.

Results: Among a total of 96,405 TTS-related admissions, 5.9% (n=5,705) were diagnosed with CS. Individuals with CS were found to have a median age of 74 (with an interquartile range of 69-80), a higher proportion of males (21.2%), and a predominantly white racial background (83.2%), all of which were statistically significant(p<0.001). Furthermore, patients diagnosed with CS experienced significantly longer hospital stays (median [IQR] 8 [4-14] vs. 4 [2-7]), incurred higher costs (median [IQR] 14.5 [8.1-28.7] vs. 5.6 [3.3-10.3]) and showed higher mortality (29.4% vs 5%) compared to those without CS (p<0.001). The prevalence of all parameters depicted in Figure 1 showed a statistically significant increasing trend over the years(p<0.05), except for Hispanics. Subgroup analysis revealed that males who had diabetes had significantly increased odds of developing CS [OR 1.57, CI 1.15-2.13, p=0.005]. Also, white individuals with diabetes had higher chance of CS [OR 1.21, CI 1.03-1.42, p<0.05].

Conclusion: Recent trends indicate a rise of CS among TTS related hospitalizations with a notable impact on different demographics such as sex and race, particularly among Asian and pacific islanders. Additionally, in-hospital mortality in patients with CS was six times higher compared to the ones without CS.