Age-sex effect on in-hospital complications and mortality in patients with Takotsubo syndrome. Insights from the National Inpatient Sample

Abstract

Age and sex differences in Takotsubo syndrome (TTS) are still a matter of debate. The aim of the present study was to evaluate the difference in cardiovascular (CV) risk factors, CV disease, in-hospital complications, and death within different sex-age groups. Using the National Inpatient Sample database between 2012 and 2016, 32,474 patients older than 18 years of age hospitalized with the primary diagnosis of TTS were identified. A total of 32.474 patients were enrolled, 27,611 (85.04%) were females. Cardiovascular risk factors were higher in females while CV diseases and in-hospital complications were significantly higher in males. The mortality in males was twice as high as that of female patients (9.83% vs 4.58%, p<0.01) and in logistic regression model after adjustment for confounders, odds ratio was 1.79, CI 1.60-2.02, p<0.01. After dividing the group based on age, in-hospital complications were inversely related to age in both sexes, and the length of in-hospital stay was double in the youngest group compared to the oldest one. Mortality increased progressively with age in both groups but was constantly higher in males for each age group. A multiple logistic regression analysis for mortality was performed for the two sexes separately and the 3 age groups considering the youngest one as the reference group. In females, the OR was 1.59 and 2.88 respectively for group 2 and 3, for males OR was 1.92 and 3.15, all of them statistically significant (p<0.01). In-hospital complications were more common in younger patients with TTS and particularly in males. Mortality was positively correlated with age for both sexes, but mortality was higher in males compared to females in all age groups.