Neighborhood data are superior to self-reported income or education as indicators of socioeconomic status in health research, because neighborhood variables are indicative of both individual socioeconomic status and broader neighborhood characteristics that
may influence health . Patient clinical variables Clinical variables were abstracted from participants’ medical records. NSTEMI/UA ACS diagnosis of NSTEMI or UA was defined by study cardiologists using ACC/AHA research definitions . Global registry of acute cardiac events (GRACE) score The GRACE score is an empirically derived prognostic risk index based on clinical predictors available at the time of Inhibitors,research,lifescience,medical an ACS . GRACE variables see more include age, history of MI or congestive heart failure, heart rate, systolic blood pressure and serum creatinine at hospital presentation, and ST segment deviation, elevated cardiac enzymes, and percutaneous intervention during hospitalization. This study received ethics approval by the Institutional Review Board (IRB) of Columbia University Medical Center (CUMC; Inhibitors,research,lifescience,medical # IRB – AAA9286). All patients were recruited from the clinical departments at NYP. Written informed consent was obtained from all study patients. Completed informed consent documents were then stored in a secure location as per CUMC IRB protocol. Statistical analysis We generated descriptive statistics
for all study variables and checked that all variables met Inhibitors,research,lifescience,medical the assumptions of linear regression. Participant characteristics were compared across depression
status using one-way analysis of variance (ANOVA) for continuous variables and chi-square analysis for categorical variables. To test the primary study hypothesis, we used multiple Inhibitors,research,lifescience,medical linear regression to regress ED LOS on age, sex, race, ethnicity, median neighborhood income, ACS type (NSTEMI vs. UA), prognosis (GRACE score), ED presentation time, and depression status. Depression status was analyzed as current depressed Inhibitors,research,lifescience,medical vs. past depressed vs. never depressed in order to isolate the potential effect of current depressive presentation on ED LOS from that of more stable depressive personality characteristics that may correspond to any history of depression. Results Of the 139 confirmed UA or NSTEMI patients who were treated in the NYP ED, consented to participate, and were found to be eligible, 120 (86%) had reliable individual-level LOS data, and each had complete data on depression and all other covariates. Thus, participants (Table Ketanserin (Table1)1) were 120 NSTEMI/UA patients [mean age= 62, 67% men, 56% Hispanic, 25% Black/African American, 39% NSTEMI, mean GRACE score= 93.5]. Fifteen patients were currently depressed, 28 had been previously depressed but were currently not depressed, and 77 had never been depressed. Mean ED LOS in the sample was 11.64 hours, SD= 8.03. Table 1 Participant characteristics The regression model (Table (Table2)2) explained 11% of the variance in ED LOS, F (11, 108)= 2.35, p= .01, R2 adj. = .11.