Disease-Specific Trends and Ethnic Inequities in In-Hospital Cardiovascular Mortality in Suriname, 2013–2022

Objective To examine temporal trends in in-hospital mortality among patients hospitalized with heart failure, ischemic heart disease, and cerebrovascular disease in Suriname from 2013 to 2022, and to assess differences according to age, sex, and ethnicity. Methods Conducted a retrospective hospital-based observational study using routinely collected discharge data from three major public hospitals in Suriname. These hospitals accounted for approximately 71.8% of national hospital admissions. Admissions with a primary diagnosis of HF (ICD-10 I50), IHD (I20–I25), or Stroke (I60–I69) were included. The primary outcome was in-hospital mortality. Separate multivariable logistic regression models were fitted for each disease, adjusting for calendar year, age, sex, and ethnicity. Results Among 84,691 admissions, 42,301 were IHD, 24,584 for Stroke, and 17,806 for HF. In-hospital mortality declined significantly across all three conditions, with adjusted odds decreasing by 14% annually for HF (aOR 0.858; 95% CI 0.841–0.875), 6% for IHD (aOR 0.941; 95% CI 0.914–0.969), and 5% for Stroke (aOR 0.947; 95% CI 0.931–0.963). Increasing age was associated with higher mortality in IHD and Stroke. Female sex was associated with lower mortality in HF (aOR 0.835; 95% CI 0.744–0.937). Ethnic disparities were most pronounced for Stroke, with higher mortality among Maroon, Creole, Javanese, and Other groups than Hindustani patients. Conclusions In-hospital mortality declined across cardiovascular conditions, but improvements were heterogeneous. Pronounced ethnic inequalities in Stroke mortality and age-related gradients highlight the need for equity-focused cardiovascular surveillance and provide a baseline for evaluating future health-system and prevention initiatives in Suriname.