This retrospective National Inpatient Sample study included 3,032 adult hospitalizations for cardiogenic shock treated with VA-ECMO during 2018–2022, examining ZIP code-level income and in-hospital mortality. Compared with the lowest-income quartile, the highest-income quartile had lower adjusted mortality risk (adjusted risk ratio 0.83; 95% confidence interval 0.74–0.94). Time-to-event analysis also showed a lower adjusted hazard of death for the highest versus lowest quartile (adjusted hazard ratio 0.76; 95% confidence interval 0.64–0.89). Mortality risk did not differ significantly between the second or third quartiles and the lowest quartile.
Higher neighborhood income was associated with lower in-hospital mortality among cardiogenic shock hospitalizations receiving VA-ECMO. These findings highlight socioeconomic disparities but do not establish their causes.
Study limitation: The retrospective design limits causal inference, and ZIP code-level income may not reflect individual socioeconomic circumstances.
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