Abstract 4140858: Racial Disparities in Cardiovascular Outcomes Among Hospitalized Patients with Diabetes Mellitus

Introduction: Patients with diabetes mellitus (DM) experience diverse cardiovascular outcomes; this study aimed to evaluate the racial disparities in cardiovascular outcomes among patients with diabetes mellitus. Method: We conducted a retrospective cohort study using the National Inpatient Sample (NIS) database 2016-2021 and ICD 10 code and identified patients with DM, categorized them based on their race. Baseline characteristics were compared using Pearson's χ2 tests and univariable linear regression. The cardiovascular outcomes were examined using multivariable logistic regression. Group comparisons were carried out using Wilcoxson signed-rank test for continuous and Pearson's χ2 tests for categorical variables. Result: We analyzed data from 47,384,595 hospitalizations for DM across racial groups in the US between 2016 and 2021. Baseline characteristics of DM among racial groups over the study period is illustrated in Table 1. The mean age was oldest among Whites (67.7 years) and Asian/Pacific Islanders (68.1 years). Cardiovascular outcomes differed across groups (Table 2). In-hospital mortality was highest among Asian/Pacific Islanders (4.3%) and lowest among Blacks (2.9%, p<0.001). Heart failure was most prevalent in Blacks (34.2%), while myocardial infarction rates were highest among Asian/Pacific Islanders (6.3%, p<0.001). Blacks and Native Americans had higher rates of ESRD (15.6% and 15.2%) than other groups, especially compared to Whites (5.8%). Amputation rates were also higher among Native Americans (6.7%) and Blacks (4.8%) than Whites (3.3%). After adjusting for demographics, hospital characteristics and comorbidities, racial minorities remained at higher risk for adverse outcomes compared to Whites. Blacks (aOR 2.19, 95%CI 2.16-2.21), Hispanics (aOR 2.54, 95%CI 2.50-2.58), Asian/Pacific Islanders (aOR 2.56, 95%CI 2.51-2.61) and Native Americans (aOR 2.87, 95%CI 2.72-3.01) all had over double the odds of ESRD. Blacks, Hispanics and Native Americans also had significantly higher adjusted odds of amputation. However, Blacks (aOR 0.66, 95%CI 0.64-0.69) and Hispanics (aOR 0.89, 95%CI 0.86-0.93) had lower odds of in-hospital mortality than Whites. Conclusion: This study highlights racial disparities in cardiovascular outcomes among hospitalizations of patients with DM. Further research should be done to explore contributing factors to these disparities to improve and curb these outcomes.