Outcomes of acute myocardial infarction in patients with preexisting physical disability: a report in the United States

ABSTRACT

Background

A significant proportion of the world’s population lives with physical disability (PD) requiring healthcare services. Risk factors for cardiovascular disease (CVD) such as hypertension and diabetes are more prevalent among patients with PD. Our study compares outcomes following acute myocardial infarction (AMI) between patients with preexisting PD and those without, using the National Inpatient Sample (NIS).

Methods and Results

We analyzed all adult inpatients having a diagnosis of AMI from 2015 to 2018. The main outcome measured was in-hospital all-cause mortality. Of 2,674,524 patients admitted with AMI, 5% had PD. Patients in the PD group were found to have higher mortality (aOR 1.13, CI 1.1–1.15 p < 0.001), with the musculoskeletal group showing the highest mortality. Patients with PD received lower rates of percutaneous coronary intervention (aOR 0.65, CI 0.64–0.66, <0.001), compared to the non-PD group, with the musculoskeletal group having the lowest rates of intervention.

Conclusion

A diagnosis of PD was independently associated with significantly increased mortality following AMI. The prognostic impact of disability correlates with the nature of the disability, with musculoskeletal disability being associated with the worst mortality outcomes. Finally, patients with any type of PD are less likely to be offered invasive cardiac management following their AMI.

KEYWORDS:

• physical disability
• acute myocardial infarction
• percutaneous coronary intervention

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.

Ethics

As the NIS is publicly available and contains no patient identifiable information, no ethical approval was needed.

Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2022.2138858

Additional information

Funding

This paper was not funded.