Demographic Factors and Aortic Stenosis-Related Death Locations: A Cross-Sectional Analysis

<b>Background</b>: Aortic stenosis (AS) imposes a significant mortality burden. Understanding demographic influences on the location of AS-related death is crucial for advancing equitable end-of-life care. Therefore, we investigated how demographic factors influence the location of death among AS patients in the United States. <b>Methods</b>: We completed a cross-sectional study utilizing US mortality data from the CDC's WONDER database for 2019. All files related to decedents with AS identified as the primary cause of death were obtained, including demographic information and death locations (i.e., inpatient facilities, outpatient/ER facilities, home, or hospice/nursing facilities). Associations between demographic factors (age, sex, race/ethnicity, marital status, and education) and place of death were assessed using multivariable logistic regression models, yielding odds ratios (ORs). <b>Results</b>: In 2019, most AS-related deaths occurred in inpatient facilities (38.3%, n = 5062), home (29.2%, n = 3859), or hospice/nursing facilities (28.6%, n = 3775). Higher odds of inpatient death were observed among Black (OR 1.67, <i>p</i> < 0.001) and Hispanic individuals (OR 1.91, <i>p</i> < 0.001) compared to White decedents. Those aged >85 years were more likely to die at home (OR 1.76, <i>p</i> < 0.001) or in hospice/nursing facilities (OR 7.80, <i>p</i> < 0.001). Males had increased odds of inpatient death (OR 1.09, <i>p</i> = 0.044) but decreased odds of hospice/nursing facility death (OR 0.87, <i>p</i> = 0.003). Higher education levels were associated with increased odds of home death (OR 1.33, <i>p</i> = 0.023) and decreased odds of hospice/nursing facility death (OR 0.71, <i>p</i> = 0.015). <b>Conclusions</b>: Demographic factors significantly influence the location of death among AS patients, emphasizing the need for culturally and socioeconomically tailored interventions to promote equitable end-of-life care.

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Publication Details

Journal
Journal of Clinical Medicine
Published
2025-03-14
DOI
https://doi.org/10.3390/jcm14061969
Primary Topic
Geriatric Care and Nursing Homes
Type
article
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article

Demographic Factors and Aortic Stenosis-Related Death Locations: A Cross-Sectional Analysis

Kwan Lee, Hoang Nhat Pham, Andrew Bacon, Reza Arsanjani et al.
Journal of Clinical Medicine
Geriatric Care and Nursing Homes
article

Demographic Factors and Aortic Stenosis-Related Death Locations: A Cross-Sectional Analysis

Kwan Lee, Hoang Nhat Pham, Andrew Bacon, Reza Arsanjani, Justin Z. Lee, Mahmoud Hassan Abdelnabi, Hesham Abdulla, Juan Farina, Mohamed Allam, Maryam Emami, Chadi Ayoub, Gerald Lim, Xuan Ci Mee
article en

Abstract

<b>Background</b>: Aortic stenosis (AS) imposes a significant mortality burden. Understanding demographic influences on the location of AS-related death is crucial for advancing equitable end-of-life care. Therefore, we investigated how demographic factors influence the location of death among AS patients in the United States. <b>Methods</b>: We completed a cross-sectional study utilizing US mortality data from the CDC's WONDER database for 2019. All files related to decedents with AS identified as the primary cause of death were obtained, including demographic information and death locations (i.e., inpatient facilities, outpatient/ER facilities, home, or hospice/nursing facilities). Associations between demographic factors (age, sex, race/ethnicity, marital status, and education) and place of death were assessed using multivariable logistic regression models, yielding odds ratios (ORs). <b>Results</b>: In 2019, most AS-related deaths occurred in inpatient facilities (38.3%, n = 5062), home (29.2%, n = 3859), or hospice/nursing facilities (28.6%, n = 3775). Higher odds of inpatient death were observed among Black (OR 1.67, <i>p</i> < 0.001) and Hispanic individuals (OR 1.91, <i>p</i> < 0.001) compared to White decedents. Those aged >85 years were more likely to die at home (OR 1.76, <i>p</i> < 0.001) or in hospice/nursing facilities (OR 7.80, <i>p</i> < 0.001). Males had increased odds of inpatient death (OR 1.09, <i>p</i> = 0.044) but decreased odds of hospice/nursing facility death (OR 0.87, <i>p</i> = 0.003). Higher education levels were associated with increased odds of home death (OR 1.33, <i>p</i> = 0.023) and decreased odds of hospice/nursing facility death (OR 0.71, <i>p</i> = 0.015). <b>Conclusions</b>: Demographic factors significantly influence the location of death among AS patients, emphasizing the need for culturally and socioeconomically tailored interventions to promote equitable end-of-life care.

Journal of Clinical MedicineVol. 14(6)
Cleveland Clinic (US), University of Arizona (US), WinnMed (US), Mayo Clinic in Florida (US)
Good health and well-being
Openalex Percentile: Top 92%
Geriatric Care and Nursing Homes
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