Mellacheruvu, Sai Priyanka

Background: Geographic and temporal distribution of disparity authorships is unclear. Our aim was to examine authorship trends in 2020-2023 American Heart Association (AHA) abstracts reporting social and demographic disparities. Methods: We reviewed 801 AHA conference abstracts, analyzing 723 reports. Regional information of authors and their reported disparities related to gender, race, region, healthcare access (HCA), comorbidities (CO), socioeconomic status (SES) were collected. Descriptive and trend analyses were performed using Chi-square tests, and Pearson's and Kendall's Tau b correlation tests. P <0.05 was considered significant. Results: We analyzed 1440 primary and senior authorships from 723 abstracts. The majority of authors (92%) were from North America, predominantly USA (90%), with a significant representation from the South (33.6%) vs. other regions (Image 1). Disparities on outcomes such as race, gender, SES, CO, geographical locations, and HCA were reported as 53.9%, 33.9%, 26.6%, 24.9%, 17.8%, and 13.6% respectively. From 2020 to 2023, there was a declining trend in authors reporting on gender (ptrend<0.001) and HCA (ptrend-0.03) disparities, whereas disparities on SES had an increasing trend (ptrend<0.001). An increase in reporting of gender disparities was associated with increased reporting of racial disparities (r = .081, τb = .081). We also found positive correlations between SES and HCA (r = .155, τb = .155). Conversely, there was a negative correlation between gender and SES (r = -0.133, τb = -0.133), and between CO and healthcare access HCA (r = -0.078, τb = -0.078). All correlations were statistically significant (p < 0.05). Conclusion: The trends show that authors have reported more SES disparities in recent times compared to HCA, race, and gender. With expected financially challenging times ahead, to address these findings, it remains important to focus research on income based equalities in HCA and outcomes.

Background: Obstructive sleep apnea (OSA) increases the risk of stroke and cardiovascular diseases. However, its impact on geriatric patients with a prior history of stroke/transient ischemic attack (TIA) has not been adequately studied. Methods: We utilized the 2019 National Inpatient Sample in the US to identify geriatric patients with OSA (G-OSA) who had a prior history of stroke/TIA. We then compared subsequent stroke (SS) rates among sex and race subgroups. We also compared the demographics and comorbidities of SS+ and SS− groups and utilized logistic regression models to assess outcomes. Results: Out of 133,545 G-OSA patients admitted with a prior history of stroke/TIA, 4.9% (6520) had SS. Males had a higher prevalence of SS, while Asian-Pacific Islanders and Native Americans had the highest prevalence of SS, followed by Whites, Blacks, and Hispanics. The SS+ group had higher all-cause in-hospital mortality rates, with Hispanics showing the highest rate compared to Whites and Blacks (10.6% vs. 4.9% vs. 4.4%, p < 0.001), respectively. Adjusted analysis for covariates showed that complicated and uncomplicated hypertension (aOR 2.17 [95% CI 1.78–2.64]; 3.18 [95% CI 2.58–3.92]), diabetes with chronic complications (aOR 1.28 [95% CI 1.08–1.51]), hyperlipidemia (aOR 1.24 [95% CI 1.08–1.43]), and thyroid disorders (aOR 1.69 [95% CI 1.14–2.49]) were independent predictors of SS. The SS+ group had fewer routine discharges and higher healthcare costs. Conclusions: Our study shows that about 5% of G-OSA patients with a prior history of stroke/TIA are at risk of hospitalization due to SS, which is associated with higher mortality and healthcare utilization. Complicated and uncomplicated hypertension, diabetes with chronic complications, hyperlipidemia, thyroid disorders, and admission to rural hospitals predict subsequent stroke.