Inverclyde Royal Hospital, Greenock
Title: Impact of Socioeconomic Deprivation on Heart Failure Management and Clinical Outcomes
Biography: Stephan Hindmarsh
In this retrospective study, 96 patients admitted with Heart failure(HF) from the most deprived and least deprived tertile of Scottish Index of Multiple Deprivation (SIMD) (1 – 3 – most deprived and 7 - 9 – least deprived).
Between the two groups, no statistical difference exists between age, gender, haemoglobin or creatinine level; nor was there any difference in past medical history or cigarette use. Patients from the lower tertile has higher incidence of alcohol excess (16% vs 3%, p = 0.043) while higher incidence of AF for the higher tertile (55% vs 33%, p = 0.004). Prescription of diuretics, Beta-Blocker, ACE-I or ARB were not statistically different. Patients from higher tertile is more likely to receive aldosterone antagonist (37% vs 17%, p = 0.031) and combined Beta-blocker and ACE-i/ARB treatment (42% vs 21%, p = 0.025).
6-months follow-up demonstrates composite endpoint of heart failure readmission and mortality was statistically higher among patients of lower socioeconomic tertile (p = 0.042). Stepwise multiple regression analysis also confirmed socioeconomic deprivation as an independent predictor for more adverse clinical outcome for heart failure (p = 0.003, R2 = 22%).
Summary: Despite the establishment of universal healthcare, patients from the lower socioeconomic group are less likely to received prognostically beneficial medication and are more likely to be experience readmission for heart failure or death