The Virginia Cardiac Services Quality Initiative (VCSQI) is committed to enhancing cardiac care through data-driven insights. A recent study presented at the 2024 Annual Meeting of the Southern Thoracic Surgical Association (STSA) utilized VCSQI data to examine the impact of race and sex on mortality rates following coronary artery bypass grafting (CABG).
Study Overview
Researchers analyzed data from 27,309 patients who underwent isolated CABG between July 2011 and July 2023 across multiple centers. Patients were categorized into four groups: white men, white women, black men, and black women. Key findings include:
Operative Mortality Rates:
White men: 1.5%
White women: 2.7%
Black men: 2.5%
Black women: 3.2%
Major Morbidity Rates:
White men: 8%
White women: 12%
Black men: 14%
Black women: 17%
These statistics reveal that black women experience the highest rates of both operative mortality and major morbidity following CABG procedures.
Risk-Adjusted Findings
After adjusting for variables such as surgical risk and socioeconomic factors, the study found that:
White women had a 1.5 times higher odds of mortality compared to white men.
Black men had a 1.41 times higher odds.
Black women faced a 1.78 times higher odds.
These disparities persisted even after accounting for factors like urgent or emergent surgical status, the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), distressed community index scores, and cardiopulmonary bypass time.
Implications and Call to Action
The study underscores the urgent need for targeted interventions to address these enduring disparities in CABG outcomes. Despite overall advancements in surgical techniques and patient care, the mortality rates for black and female patients have not shown significant improvement over the study period. This stagnation highlights the necessity for renewed efforts to ensure equitable healthcare outcomes for all patients undergoing CABG.
The research team advocates for comprehensive strategies that encompass both clinical and socioeconomic dimensions to mitigate these disparities. By focusing on tailored patient care and addressing broader systemic issues, the goal is to enhance survival rates and quality of life for all individuals requiring coronary artery bypass grafting.
This presentation at the STSA Annual Meeting serves as a critical reminder that while progress has been made in cardiac surgery, there is still significant work to be done to achieve equity in patient outcomes.
Acknowledgment
We extend our gratitude to the dedicated researchers who conducted this study:
Anthony V. Norman, MD
Mohamad El Moheb, MD
Alexander M. Wisniewsk, MDi
Matthew P. Weber, MD
Steven Young, MD
Andrew M. Young, MD
Abdulla Damluji, MD
Michael C. Kontos, MD
Mohammed Quader, MD
Ourania Preventza, MD
Nicholas R. Teman, MD
Their commitment to advancing cardiac care through rigorous research is invaluable to our mission.
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