Nationwide readmission analysis of socioeconomic disparities in heart failure hospitalizations among patients with substance-induced cardiomyopathy.

Abstract

Lower socioeconomic status (SES) is associated with adverse cardiovascular outcomes; however, limited data exist on heart failure (HF) hospitalizations among patients with substance-induced cardiomyopathy (SICM). We analyzed the 2016-2019 Nationwide Readmissions Database to identify HF cases with SICM. Patients were stratified by zip code income quartiles (≤2 [< $59,000] vs. ≥3). The primary outcome was mortality. Secondary outcomes included 90-day readmissions, acute kidney injury (AKI), cardiac arrest, length of stay (LOS), and total hospitalization charges (THC). Multivariable regression models adjusted for confounders. Among 8443 HF admissions with SICM, 59 % were lower-income patients. Lower income was associated with increased 90-day readmissions (adjusted OR [aOR] 1.18; 95 % CI, 1.03-1.35), shorter mean LOS (6.2 vs. 7.0 days) and lower THC ($81,702 vs. $105,904). No differences were observed in mortality, AKI, or cardiac arrest. Among HF-SICM cases, lower-income was associated with higher readmission risk despite shorter stays and lower charges.