Effect of Neighborhood Socioeconomic Factors on Readmissions and Mortality After Coronary Artery Bypass Grafting.

The Annals of Thoracic Surgery
Garrett N CoyanDanny Chu

Abstract

Social determinants of health, including neighborhood socioeconomic status (NSES), are increasingly being associated with disparate outcomes in those undergoing cardiac procedures. The objective of this study was to determine the effect of NSES on outcomes after coronary artery bypass grafting (CABG). Adults undergoing isolated CABG between July 2011 and December 2017 were retrospectively reviewed. Neighborhood median household income (NMI) and neighborhood high school graduation rate (NHS) were obtained by individual patient ZIP code from the American FactFinder Database. Primary outcome was 5-year all-cause mortality stratified by NMI quartile. Secondary end points included mortality risk by NHS, freedom and frequency of readmission, and mortality and readmission predictors. During the study period, 5243 patients underwent CABG. Increasing NMI quartile was associated with increasing age, male sex, white race, decreased diabetes prevalence, decreased active smoker status, and decreased lung disease (all P < .05). Although no difference in 30-day mortality was observed, lower NMI quartiles were associated with increased longitudinal mortality through 5 years (log-rank P < .01). Lower NMI quartile was associated with increased b...Continue Reading

References

Apr 8, 2010·Circulation. Cardiovascular Quality and Outcomes·Colleen G KochEugene H Blackstone
May 31, 2014·The Physician and Sportsmedicine·Garrett N CoyanJames L Vacek
Oct 24, 2015·Journal of the American College of Cardiology·Magnus DalénUlrik Sartipy
Oct 26, 2016·Journal of Vascular Surgery·Loay S KabbaniAlexander D Shepard
Sep 8, 2017·BMC Cardiovascular Disorders·Elise SverreJohn Munkhaugen
May 16, 2018·Circulation·William M SchultzLaurence S Sperling
Oct 17, 2018·The Annals of Thoracic Surgery·Jeffrey P JacobsKeith S Naunheim
Nov 6, 2018·The American Journal of Cardiology·Fenton H McCarthyMatthew L Williams
Jan 17, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jawad H ButtEmil L Fosbøl
Jan 27, 2019·The Annals of Thoracic Surgery·Eric J CharlesUNKNOWN Investigators for the Virginia Cardiac Services Quality Initiative

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