Abstract 17329: Characterizing Disparities Among Frail Cardiovascular Patients
| Autor: | Arati A Gangadharan, Chloé A. Powell, Matthew A. Corriere, Gloria Y. Kim |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Circulation. 142 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.142.suppl_3.17329 |
| Popis: | Introduction: Frailty is associated with increased risk of adverse health events among cardiovascular patients. Phenotype-based approaches to frailty assessment typically rely upon sex and body mass index as co-variables. Hypothesis: We hypothesized that race, ethnicity, disadvantaged community index (DCI), and health insurance coverage are associated with frailty. To test this hypothesis, we prospectively measured grip strength in a cohort of cardiovascular patients and evaluated the relationships of frailty with disparity measures. Methods: Patients treated in outpatient cardiovascular center clinics were evaluated for frailty using dominant hand grip strength. Grip strength, adjusted by gender and BMI, were used to determine frailty. Insurance status was categorized as Private, Medicaid, or Medicare based on primary coverage. Frailty was then evaluated stratified by DCI and health insurance status. Associations were evaluated using multivariable models. Results: Over 10 months, 3,986 patient grips were measured. Of these, 34.9% (n=1,392) were considered frail. Mean age was 63.5±15.6 years and 47.3% (n=1,885) were female. African American/black made up 7.73% (n=308) of the cohort and Asians/Pacific Islander 2.13% (n=85). A third of patients (32.7%) had private insurance, 2,187 (54.9%) had Medicare, and 291 (7.3%) had Medicaid. The average DCI score was 35.3±27.6. Patients with Medicare had the highest prevalence of frailty (47.4% versus 17.0% for Private Insurance and 26.5% for Medicaid; P Conclusions: When assessing insurance status related to frailty, frailty incidence was highest among patients with Medicaid insurance status. Further, age, race, insurance status, and distressed community index are associated with frailty defined by grip strength among cardiovascular patients. There may be a large segment of at-risk individuals who are missed because they do not fit the well characterized variables associated with frailty, including older age, female gender, both high and low BMI, and functional decline. |
| Databáze: | OpenAIRE |
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