title: Gender- and race-based utilization and outcomes of pulmonary artery catheterization in the setting of full-time intensivist staffing.
abstract: BACKGROUND
  Little is known regarding gender- or race-based differences in critical care. We investigated whether gender or race was associated with pulmonary artery catheter (PAC) utilization or with in-hospital death among patients with a PAC. A particular focus was patients with cardiogenic shock (CS), in whom guidelines recommend PAC use.
  
  
  METHODS
  This was a retrospective cohort analysis from the coronary care unit of a large tertiary-care hospital staffed with full-time cardiac intensivists.
  
  
  RESULTS
  We analyzed 8845 consecutive adult patients, of whom 42.1% were women and 40.8% were black. PAC use rates were 11.3% in women and 11.5% in men (P = 0.79), and 11.3% in blacks and 11.5% in whites (P = 0.76). In CS patients, PAC use rates in women and men were 50.3% and 49.1% (P = 0.85) and in blacks and whites were 43.7% and 53.3% (P = 0.05). There was no independent association between gender or race and PAC use overall or in those with CS. Neither gender nor race was a predictor of in-hospital death in patients undergoing PAC.
  
  
  CONCLUSIONS
  PAC use and in-hospital death were determined not by gender or race but by disease severity. Full-time intensivist staffing and the presence of definitive guidelines may reduce gender- and race-based treatment disparities.
authors.affiliation: Department of Medicine, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Micaela
authors.initials: M
authors.lastname: Iantorno
authors.forename: Julio A
authors.initials: JA
authors.lastname: Panza
authors.forename: Nakela L
authors.initials: NL
authors.lastname: Cook
authors.forename: Samantha
authors.initials: S
authors.lastname: Jacobs
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Ritchey
authors.forename: Kathryn
authors.initials: K
authors.lastname: O'Callaghan
authors.forename: Daniel
authors.initials: D
authors.lastname: Caños
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cooper
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002407:Catheterization, Swan-Ganz / Q000706:statistics & numerical data*; D003325:Coronary Care Units; D003422:Critical Care; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D020445:Hospitalists / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000628:therapy*; D000078329:Workforce