Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury

The majority of the burden of firearm injury in the United States is on men as compared to women. There is limited evidence regarding sex differences in short-term hospitalization outcomes after surviving firearm injury. The risk of cardiovascular and all-cause hospital readmission, length of stay (...

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Main Authors: Yi Zuo, Elizabeth C Pino, Mrithyunjay Vyliparambil, Bindu Kalesan
Format: Article
Language:English
Published: SAGE Publishing 2018-07-01
Series:American Journal of Men's Health
Online Access:https://doi.org/10.1177/1557988318761989
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spelling doaj-fb7d72ef059f47e6b4b88244d9ee59132020-11-25T03:27:18ZengSAGE PublishingAmerican Journal of Men's Health1557-98831557-98912018-07-011210.1177/1557988318761989Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm InjuryYi Zuo0Elizabeth C Pino1Mrithyunjay Vyliparambil2Bindu Kalesan3Center for Clinical Translational Epidemiology and Comparative Effectiveness Research, Department of Medicine, Boston University School of Medicine, Boston, MA, USACenter for Clinical Translational Epidemiology and Comparative Effectiveness Research, Department of Medicine, Boston University School of Medicine, Boston, MA, USADepartment of Health Sciences, University of Massachusetts, Lowell, MA, USACenter for Clinical Translational Epidemiology and Comparative Effectiveness Research, Sections of Preventive Medicine, Department of Medicine and Community Health Science, Boston University School of Medicine and Public Health, Boston, MA, USAThe majority of the burden of firearm injury in the United States is on men as compared to women. There is limited evidence regarding sex differences in short-term hospitalization outcomes after surviving firearm injury. The risk of cardiovascular and all-cause hospital readmission, length of stay (LOS), and costs within 180 days after surviving an index firearm injury was compared between males and females. A claims-based, retrospective, cohort study was performed using Nationwide Readmission Database (2013–2014) to obtain a cohort of patients who survived an index hospitalization of firearm injury. The analysis was performed in August 2017. Cox proportional hazard regression models were used to estimate hazard ratio (HR) and 95% confidence intervals (95% CIs). Among 17,594 males and 2,289 females discharged alive after index firearm injury hospitalization, 14.4% and 13.2% were readmitted within 180 days. Within 180 days, the risk of cardiovascular readmission was 3.3 times greater among males versus females (HR = 3.34, 95% CI [1.18, 9.44]. Risk of all-cause readmission among males was greater at 90 days (HR = 1.40, 95% CI [1.04, 1.87]. Patients surviving a firearm injury have a substantial risk of subsequent hospitalizations. Cardiovascular readmissions are greater among males than females during the first 6 months after injury and may be indicative of a continuing long-term risk of health and patient outcomes that contributes to the overall burden of firearm injury.https://doi.org/10.1177/1557988318761989
collection DOAJ
language English
format Article
sources DOAJ
author Yi Zuo
Elizabeth C Pino
Mrithyunjay Vyliparambil
Bindu Kalesan
spellingShingle Yi Zuo
Elizabeth C Pino
Mrithyunjay Vyliparambil
Bindu Kalesan
Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
American Journal of Men's Health
author_facet Yi Zuo
Elizabeth C Pino
Mrithyunjay Vyliparambil
Bindu Kalesan
author_sort Yi Zuo
title Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
title_short Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
title_full Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
title_fullStr Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
title_full_unstemmed Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
title_sort sex differences in early cardiovascular and all-cause hospitalization outcomes after surviving firearm injury
publisher SAGE Publishing
series American Journal of Men's Health
issn 1557-9883
1557-9891
publishDate 2018-07-01
description The majority of the burden of firearm injury in the United States is on men as compared to women. There is limited evidence regarding sex differences in short-term hospitalization outcomes after surviving firearm injury. The risk of cardiovascular and all-cause hospital readmission, length of stay (LOS), and costs within 180 days after surviving an index firearm injury was compared between males and females. A claims-based, retrospective, cohort study was performed using Nationwide Readmission Database (2013–2014) to obtain a cohort of patients who survived an index hospitalization of firearm injury. The analysis was performed in August 2017. Cox proportional hazard regression models were used to estimate hazard ratio (HR) and 95% confidence intervals (95% CIs). Among 17,594 males and 2,289 females discharged alive after index firearm injury hospitalization, 14.4% and 13.2% were readmitted within 180 days. Within 180 days, the risk of cardiovascular readmission was 3.3 times greater among males versus females (HR = 3.34, 95% CI [1.18, 9.44]. Risk of all-cause readmission among males was greater at 90 days (HR = 1.40, 95% CI [1.04, 1.87]. Patients surviving a firearm injury have a substantial risk of subsequent hospitalizations. Cardiovascular readmissions are greater among males than females during the first 6 months after injury and may be indicative of a continuing long-term risk of health and patient outcomes that contributes to the overall burden of firearm injury.
url https://doi.org/10.1177/1557988318761989
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