Racial disparities in utilization of ECMO in COVID-19 patients: a retrospective population-based analysis

• Authors: Mohannad Al Akeel , Jefferson Thompson , Shahnawaz Notta , Jeetendra Patel , Mahmoud Abdelghany

Abstracts

EN

INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a crucial intervention for severe respiratory failure, including in cases of COVID-19. Medical research has shown disparities in multiple fields of healthcare as well as in the utilisation of ECMO. Racial disparities in the utilisation of ECMO among COVID-19 patients are a concern, which requires investigation to ensure equitable access to life-saving treatments. To our knowledge, no study that have specifically evaluated the utilisation of ECMO among COVID-19 patients. Our aim from this study is to explore racial disparities in healthcare care, and specifically in the use of ECMO. The objective of the study was to evaluate any possible disparities that exist in the odds of receiving ECMO based on race after correcting for other confounding factors in patients admitted with COVID-19 pneumonia. MATERIALS AND METHODS: This retrospective study analysed data from the National Inpatient Sample (NIS) database spanning 2019 to 2020. A total of 1,507,585 admissions for COVID-19 pneumonia were examined, of which 3,070 required ECMO. Statistical analyses, including adjusted odds ratios and multivariate logistic regression models, were employed to assess the association between race and ECMO utilisation using STATA 17 version RESULTS: The mean age of the studied population was 48.85 with a standard deviation of 0.5. 1075 white patients have utilized the ECMO when admitted to the hospital, compared to 605 black patients, 1055 Hispanics, 90 Asians, 75 Native Americans and 170 patients in ‘Others’ race group. Adjusted odds ratios for receiving ECMO, compared to Whites as the reference group, did not reveal statistically significant differences for African Americans (OR 1.03; 95% CI 0.75 - 1.40; P value = 0.86) and Asians (OR 1.04; 95% CI 0.75 - 1.75; P value = 0.86). Hispanics showed a significantly higher probability of receiving ECMO (OR 1.32; 95% CI 1.01 - 1.73; P-value=0.04), as did Native Americans (OR 2.16; 95% CI 1.18 - 3.94; P-value=0.012). CONCLUSIONS: Addressing disparities in ECMO utilisation is crucial to ensure equitable access to lifesaving interventions among COVID-19 patients. Strategies to mitigate racial disparities in healthcare access and treatment are essential to optimise patient outcomes and fostering health equity.

Keywords

EN

Critical care; adult respiratory distress syndrome; mechanical circulatory support; ECMO; COVID

• Publisher: Towarzystwo Pomocy Doraźnej
• Journal: Critical Care Innovations
• Year: 2024
• Volume: 7
• Issue: 2
• Pages: 12-19

Dates

published

2024

Contributors

author

Mohannad Al Akeel

• Department of Internal medicine, East Tennessee State University, Johnson City, TN, USA

• https://orcid.org/0009000972632318

author

Jefferson Thompson

• Department of Internal medicine, East Tennessee State University, Johnson City, TN, USA

• https://orcid.org/0009000067089941

author

Shahnawaz Notta

• Department of Internal medicine, East Tennessee State University, Johnson City, TN, USA

• https://orcid.org/0009000483516826

author

Jeetendra Patel

• Department of Cardiovascular disease, East Tennessee State University, Johnson City, TN, USA

• https://orcid.org/0009000675629219

author

Mahmoud Abdelghany

• Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

• https://orcid.org/0000000206432168

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Identifiers

DOI

10.32114/CCI.2024.7.2.12.19

Biblioteka Nauki

55783225