Race and patient refusal of invasive cardiac procedures

Journal of General Internal Medicine
Howard S GordonNelda P Wray

Abstract

To determine whether patients' decisions are an important determinant of nonuse of invasive cardiac procedures and whether decisions vary by race. Observational prospective cohort. Patients (N= 681) enrolled at the exercise treadmill or the cardiac catheterization laboratories at a large Veterans Affairs hospital. Doctors' recommendations and patients' decisions were determined by both direct observation of doctor and patient verbal behavior and by review of medical charts. Performance of coronary angiography, angioplasty, and bypass surgery were determined by chart review for a minimum of 3 months follow-up. Coronary angiography was recommended after treadmill testing for 83 of 375 patients and 72 patients underwent angiography. Among 306 patients undergoing angiography, recommendations for coronary angioplasty or bypass surgery were given to 113 and 45 patients and were completed for 98 and 33 patients, respectively. Recommendations were not significantly different by race. However, 4 of 83 (4.8%) patients declined or did not return for recommended angiograms and this was somewhat more likely among black and Hispanic patients, compared with white patients (13% and 33% vs 2%; P =.05). No patients declined angioplasty and 2 of ...Continue Reading

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Citations

Feb 28, 2008·Journal of General Internal Medicine·Somnath SahaSaid Ibrahim
Apr 13, 2010·Journal of General Internal Medicine·Brian J Ayotte, Nancy R Kressin
Sep 13, 2006·The Journal of Cardiovascular Nursing·Marilyn HravnakJoseph Conigliaro
Oct 19, 2007·Medical Care Research and Review : MCRR·Andrew M DavisElbert S Huang
Aug 31, 2004·Journal of General Internal Medicine·Lisa A Cooper
Mar 18, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kimberly D MartinJudith H Lichtman
Oct 4, 2015·International Journal of Cardiology·Ike S OkwuosaClyde W Yancy
Apr 25, 2007·American Heart Journal·Ashish K JhaAmitabh Chandra
Sep 4, 2015·Global Advances in Health and Medicine : Improving Healthcare Outcomes Worldwide·Suzanne E MitchellNancy R Kressin
Apr 22, 2015·Current Cardiology Reports·Rohan KheraSaket Girotra
Mar 17, 2005·Circulation·George A MensahJanet B Croft
Aug 16, 2006·Cancer·Howard S GordonJulianne Souchek
Nov 29, 2007·Anesthesia and Analgesia·Edward Andrew OchrochJohn T Farrar
Nov 6, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Shreyas GowdarW Lane Duvall

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