Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

Cooper, William A.; Thourani, Vinod H.; Guyton, Robert A.; Kilgo, Patrick D.; Lattouf, Omar M.; Chen, Edward P.; Morris, Cullen D.; Vega, J. David; Vassiliades, Thomas A.; Puskas, John D.

doi:10.1161/circulationaha.108.843763

Cited by 32 publications

(26 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4][5] However, results of CABG surgery have improved markedly over the past decade and it is unclear whether these older data reflect contemporary outcomes. Additionally, some of these previous studies evaluated data from a single state or small group of institutions and may not reflect national results.…”

mentioning

confidence: 99%

“…Previously hypothesized explanations for the disparities in outcomes have included demographics and socioeconomic differences, comorbid illness, disease severity, and presenting characteristics. [1][2][3][4][5] The association of the hospital and physician characteristics, and the quality of care delivered to these patients, as well, with the race-related differences in outcomes after CABG has not been fully elucidated.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Association of Hospital and Physician Characteristics and Care Processes With Racial Disparities in Procedural Outcomes Among Contemporary Patients Undergoing Coronary Artery Bypass Grafting Surgery

et al. 2016

View full text Add to dashboard Cite

Background-Previous studies have reported that black patients undergoing coronary artery bypass surgery had worse outcomes than white patients, even after accounting for patient factors. The degree to which clinician, hospital, and care factors account for these outcome differences remains unclear. Methods and Results-We evaluated procedural outcomes in 11 697 blacks and 136 362 whites undergoing isolated coronary artery bypass surgery at 663 Society of Thoracic Surgery Database participating sites (January 1, 2010 to June 30, 2011) adjusted for patients' clinical and socioeconomic features, hospital and surgeon effects, and care processes (internal mammary artery graft and perioperative medications use). Relative to whites, blacks undergoing coronary artery bypass surgery were younger, yet had higher comorbidities and more adverse presenting features. Blacks were also more likely to be treated at hospitals with higher risk-adjusted mortality. The use of internal mammary artery was marginally lower in blacks than in whites (93.3% versus 92.2%, P<0.0001). Unadjusted mortality and major morbidity rates were higher in blacks than in whites (1.8% versus 2.5%, P<0.0001) and (13.6% versus 19.4%, P<0.0001), respectively. These racial differences in outcomes narrowed but still persisted after adjusting for surgeon, hospital, and care processes in addition to patient and socioeconomic factors (odds ratio, 1.17; 95% confidence interval, 1.00-1.36 and odds ratio, 1.26; 95% confidence interval, 1.19-1.34, respectively). Conclusions-The risks of procedural mortality and morbidity after coronary artery bypass surgery were higher among black patients than among white patients. These differences were in part accounted for by patient comorbidities, socioeconomic status, and surgeon, hospital, and care factors, as well, as suggested by the reduction in the strength of the race-outcomes association. However, black race remained an independent predictor of outcomes even after accounting for these differences.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Association of Hospital and Physician Characteristics and Care Processes With Racial Disparities in Procedural Outcomes Among Contemporary Patients Undergoing Coronary Artery Bypass Grafting Surgery

et al. 2016

View full text Add to dashboard Cite

show abstract

“…It has been shown that patients with preexisting low ejection fraction (EF) are at a higher risk of developing respiratory problems than patients with normal EF (11,12,(32)(33)(34)(35)(36). Impaired left ventricular ejection fraction (LVEF) of less than 30%, history of previous myocardial infarction (36,37), and preexisting congestive heart failure, age, diabetes mellitus and arterial hypertension, have all been shown to be independent, significant predictors for developing these respiratory problems (30,31,35).…”

Section: Underlying Function Of the Left Ventriclementioning

confidence: 99%

“…It has also been demonstrated that in patients undergoing CABG combined with valve disease, there is an increased possibility that the patients would require readmission to the ICU. In such patients, post-operative respiratory complications are the most common reasons for readmission (32)(33)(34)(36)(37)(38). In addition, a history of myocardial infarction during the last 90 days and a previous history of cardiac surgery, are both considered to be important predictors of postoperative respiratory problems (36-40).…”

Section: Underlying Function Of the Left Ventriclementioning

confidence: 99%

“…It is also, considered to be a major risk factor for patients undergoing CABG, which could predict the possibility of postoperative mortality and morbidity in these patients, especially for diabetic patients with respiratory problems (30)(31)(32)(33)(34)(35)(36)(37)(38). On the other hand, there is a great amount of current evidence that demonstrates a very clear difference between, well controlled and poorly controlled diabetes mellitus, in predicting respiratory problems, hence, controlling the level of blood glucose in diabetics (at least below 200 mg/dL blood levels) would greatly affect the overall clinical outcome, including respiratory outcomes, in patients undergoing cardiac surgery, especially CABG, compared with poorly controlled diabetics (35)(36)(37).…”

Section: Preexisting Endocrine Disordersmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Rajaei

Dabbagh²

2012

anesthpain

View full text Add to dashboard Cite

show abstract

Same‐day parathyroidectomy for primary hyperparathyroidism –an over 20‐year practice

Annesi,

Gillis,

Fazendin

et al. 2024

World j. surg.

View full text Add to dashboard Cite

IntroductionThere has been a shift in recent years toward same‐day parathyroidectomies due to the decrease in mutual costs with few significant differences in postoperative morbidity or mortality. We sought to determine if demographics, preoperative patient risk factors, or comorbidities were associated with a patient's likelihood of having same‐day or inpatient surgery.Materials and MethodsA prospective database of parathyroid operations from 2001 to 2022 (n = 2948 patients) was reviewed for surgeries completed for primary hyperparathyroidism. Patients were categorized as same‐day or inpatient surgery; demographics, risk factors, and co‐morbidities were examined and differences across practice patterns during the 21‐year period were studied and also analyzed in a subset of patients from 2013 to 2022.ResultsIn a recent subset of patients from 2013 to 2022, patients having inpatient surgery were more likely to be Black and use anticoagulation or antiplatelet therapy. Multivariable regression confirmed increased odds of aging and black patients requiring inpatient parathyroidectomy. Compared to 2001–2003, there was a significantly increased proportion of patients undergoing same‐day surgery; compared to 2010–2012, there was a similar proportion of patients undergoing outpatient surgery between 2013 and 2018, and there was an increased proportion from 2019 through 2022.ConclusionSame‐day parathyroidectomies have been shown to be safe and has become the typical practice for high‐volume parathyroid surgeons over the last decade. Complications such as postoperative hematoma or hypocalcemia were previously shown to be incompletely mitigated by increased LOS or inpatient surgery, although demographics are considered to increase the odds of inpatient parathyroidectomy.

show abstract

Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

Cited by 32 publications

References 23 publications

Association of Hospital and Physician Characteristics and Care Processes With Racial Disparities in Procedural Outcomes Among Contemporary Patients Undergoing Coronary Artery Bypass Grafting Surgery

Association of Hospital and Physician Characteristics and Care Processes With Racial Disparities in Procedural Outcomes Among Contemporary Patients Undergoing Coronary Artery Bypass Grafting Surgery

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Same‐day parathyroidectomy for primary hyperparathyroidism –an over 20‐year practice

Contact Info

Product

Resources

About