Persistent Racial Disparities In Outcomes After Coronary Artery Bypass Surgery
*Zachary O Enumah1, *Joseph Canner1, *Diane Alejo1, *Xun Zhou1, *Gayane Yenokyan2, *Thomas Matthew1, Jennifer Lawton1, Robert S.D Higgins1
1Johns Hopkins Hospital, Baltimore, MD;2Johns Hopkins School of Public Health, Baltimore, MD
Objective: Cardiovascular diseases remain the top cause of death in the U.S. with increased morbidity and mortality seen for black patients. In today’s era, studies of racial disparities in coronary artery bypass (CAB) are outdated. We seek to update racial disparities data.
Methods: We performed a retrospective analysis of the Society for Thoracic Surgeons database for patients undergoing CAB between 2011 and 2018. Primary exposure was race and primary outcome was 30-day mortality. Descriptive and regression statistical analyses were performed.
Results: The study population was 1,042,506 patients who underwent CAB. Black patients had higher rates of hypertension, chronic lung disease, end stage renal disease, and chronic heart failure. Compared with whites, blacks had higher overall mortality (2.76% v. 2.19%, p < .001), and higher rates of sepsis, pneumonia, post-operative stroke, and prolonged ventilation. In regression analysis, black patients had higher odds of 30-day mortality compared to white patients: univariate OR 1.27 (95% CI 1.21 to 1.33); multivariate regression OR 1.10 (95% CI 1.05 to 1.16).
Conclusion: In today’s era, racial disparities in mortality and post-operative morbidity after coronary bypass surgery persist even after adjustment, suggesting an unexplored association. Future research should focus on eliciting causes not captured in databases.
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