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Titolo:
Do race and gender influence the use of invasive procedures?
Autore:
Watson, RE; Stein, AD; Dwamena, RC; Kroll, J; Mitra, R; McIntosh, BA; Vasilenko, P; Holmes-Rovner, MM; Chen, Q; Kupersmith, J;
Indirizzi:
Michigan State Univ, Coll Human Med, E Lansing, MI 48824 USA Michigan State Univ E Lansing MI USA 48824 n Med, E Lansing, MI 48824 USA
Titolo Testata:
JOURNAL OF GENERAL INTERNAL MEDICINE
fascicolo: 4, volume: 16, anno: 2001,
pagine: 227 - 234
SICI:
0884-8734(200104)16:4<227:DRAGIT>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; CORONARY HEART-DISEASE; OF-VETERANS-AFFAIRS; BYPASS GRAFT-SURGERY; SEX-DIFFERENCES; CARDIAC PROCEDURES; REVASCULARIZATION PROCEDURES; ARTERY DISEASE; INTERVENTION-REGISTRY; RACIAL-DIFFERENCES;
Keywords:
heart catheterization utilization; angioplasty, transluminal, coronary, utilization; coronary artery bypass utilization; sex factors; blacks;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
55
Recensione:
Indirizzi per estratti:
Indirizzo: Watson, RE Michigan State Univ, Coll Human Med, B 338 Clin Ctr, E Lansing,MI 48824 USA Michigan State Univ B 338 Clin Ctr E Lansing MI USA 48824 4 USA
Citazione:
R.E. Watson et al., "Do race and gender influence the use of invasive procedures?", J GEN INT M, 16(4), 2001, pp. 227-234

Abstract

OBJECTIVE: To assess the influence of race and gender on the use of invasive procedures in patients with acute myocardial infarction (AMI) in community hospitals. DESIGN: Prospective, observational. SETTING: Five mid-Michigan community hospitals. PATIENTS: All patients (838) identified with AMI between January 1994 and April 1995 in 1 of these hospitals. MEASUREMENTS AND MAIN RESULTS: After adjusting for age, hospital of admission, insurance type, severity of AMI, and comorbidity, using white men as the reference group, the rate of being offered cardiac catheterization (CC) was 0.88 (95% confidence interval [CI], 0.60 to 1.29) for white women; 0.79(95% CI, 0.41 to 1.50) for black men; and 1.14 (95% CI, 0.53 to 2.45) for black women. Among patients who underwent CC, after also adjusting for coronary artery anatomy, the rate of being offered angioplasty, using white menas the reference group, was 1.22 (95% CI, 0.75 to 1.98) for white women: 0.61 (95% CI, 0.29 to 1.28; P = .192) for black men; and 0.40 (95% CI, 0.14 to 1.13) for black women. The adjusted rate of being offered bypass surgerywas 0.47 (95% CI, 0.24 to 0.89) for white women; 0.36 (95% CI, 0.12 to 1.06) for black men; and 0.37 (95% CI, 0.11 to 1.28) for black women. CONCLUSIONS: Our study shows that white women are less Likely than white men to be offered bypass surgery after AMI. Although black men and women with AMI are less likely than white men to be offered percutaneous transluminal coronary angioplasty or coronary artery bypass grafting in bath unadjusted and adjusted analyses, these findings did not reach statistical significance. Our study is limited in power due to the small number of blacks in thesample.

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Documento generato il 23/01/20 alle ore 04:05:18