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Persistent Racial and Sex Disparities in Outcomes After Coronary Artery Bypass Surgery
- Source :
- Annals of Surgery. 272:660-667
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- OBJECTIVE The purpose of this study was to assess the temporal trends in 30-day mortality by race group for patients undergoing coronary artery bypass grafting (CABG) between 2011 and 2018 and to investigate the effect of race and sex on postoperative outcomes after CABG. SUMMARY BACKGROUND DATA Cardiovascular diseases remain a leading cause of death in the United States with studies demonstrating increased morbidity and mortality for black and female patients undergoing surgery. In the post drug-eluting stent era, studies of racial disparities CABG are outdated. METHODS We performed a retrospective analysis of the Society for Thoracic Surgeons database for patients undergoing CABG between 2011 and 2018. Primary outcome was 30-day mortality. Secondary outcomes included postoperative length of stay, surgical site infection, sepsis, pneumonia, stroke, reoperation, reintervention, early extubation, and readmission. RESULTS The study population was comprised of 1,042,506 patients who underwent isolated CABG between 2011 and 2018. Among all races, Black patients had higher rates of preoperative comorbidities. Compared with White patients, Black patients had higher overall mortality (2.76% vs 2.19%, P < 0.001). On univariable regression, Black patients had higher rates of death, infection, pneumonia, and postoperative stroke compared to White patients. On multivariable regression, Black patients had higher odds of 30-day mortality compared to white patients [odds ratio (OR) = 1.11, 95% confidence interval (CI) 1.05-1.18]. Similarly, female patients had higher odds of death compared to males (OR = 1.26, 95% CI 1.21-1.30). CONCLUSIONS In the modern era, racial and sex disparities in mortality and postoperative morbidity after coronary bypass surgery persist with Black patients and female patients consistently experiencing worse outcomes than White male patients. Although there may be unknown or underappreciated biological mechanisms at play, future research should focus on socioeconomic, cultural, and multilevel factors.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Coronary Artery Disease
White People
Young Adult
03 medical and health sciences
Coronary artery bypass surgery
Postoperative Complications
0302 clinical medicine
Internal medicine
Humans
Medicine
Registries
Coronary Artery Bypass
Sex Distribution
Stroke
Aged
Retrospective Studies
Cause of death
Aged, 80 and over
business.industry
Stent
Drug-Eluting Stents
Health Status Disparities
Odds ratio
Middle Aged
medicine.disease
United States
Black or African American
Treatment Outcome
Bypass surgery
Drug-eluting stent
030220 oncology & carcinogenesis
Population study
Female
030211 gastroenterology & hepatology
Surgery
business
Subjects
Details
- ISSN :
- 15281140 and 00034932
- Volume :
- 272
- Database :
- OpenAIRE
- Journal :
- Annals of Surgery
- Accession number :
- edsair.doi.dedup.....6cff01323ef58932da70a4ab1de1aca1