Abstract
BACKGROUND: Sex disparities in cardiovascular disorders are well-documented, but data on hospitalization and readmission outcomes in the context of sex for Complete Heart Block (CHB) remains limited. METHODS: We analyzed the 2016-2020 Nationwide Readmission Database to identify patients with a principal diagnosis of CHB. Men served as the control group, while women comprised the study cohort. The primary outcome was mortality. Secondary outcomes included odds of cardiac arrest, ventricular tachycardia, heart failure, mechanical ventilation use, all-cause 30-day readmission, total and early pacemaker use, length of stay (LOS), and total hospitalization charges (THC). Multivariate regression models adjusted for confounders. RESULTS: Among 175,257 patients with CHB, 45% were female. Female sex was associated with higher odds of mortality (adjusted OR [aOR] 1.42, 95% CI 1.3-1.55) compared to males. Additionally, females had higher odds of cardiac arrest (aOR 1.13, 95% CI 1.06-1.2), ventricular tachycardia (aOR 1.1, 95% CI 1.05-1.17), heart failure (aOR 1.18, 95% CI 1.14-1.22), mechanical ventilation use (aOR 1.1, 95% CI 1.03-1.17), and all-cause 30-day readmission (aOR 1.1, 95% CI 1.03-1.14). Women also had lower odds of total pacemaker use (aOR 0.92, 95% CI 0.88-0.96) and early pacemaker use (aOR 0.89, 95% CI 0.86-0.82). Female patients exhibited longer LOS (4.13 days vs. 3.86 days, p < 0.001) but incurred lower THC ($89,908 vs. $94,590, p = 0.002). CONCLUSION: Female sex in CHB patients was associated with higher mortality and adverse events but lower pacemaker use compared to male patients.