Journal article
The Association of Socioeconomic Factors With Outcomes for Coronary Artery Bypass Surgery
The Annals of thoracic surgery, v 114(4), pp 1318-1325
01 Oct 2022
PMID: 34774814
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Numerous studies have identified the associations of socioeconomic factors with outcomes of cardiac procedures. The majority have focused on easily measured factors like sex, race, and insurance status, or on socioeconomic characteristics of patients’ 5-digit zip codes. The impact of more granular census-derived socioeconomic information on outcomes has rarely been studied.
The independent impact of the Area Deprivation Index (ADI) on short-term mortality and readmissions was tested on patients undergoing isolated coronary artery bypass grafting (CABG) surgery in New York by using it in logistic regression models in conjunction with patient risk factors and typical disparities measures (race, ethnicity, payer). Changes in hospitals’ risk-adjusted outcomes and outlier status with the addition of socioeconomic measures were also tested.
After adjusting for numerous patient characteristics, patients in the fourth and fifth highest ADI quintiles (most deprived) were more likely to experience in-hospital/30-day mortality after CABG surgery (adjusted odds ratio [AOR] 1.54, 95% confidence interval [CI] 1.08, 2.20; and AOR 1.50, 95% CI 1.02, 2.21), respectively. ADI was not associated with readmissions, but African Americans (AOR 1.49, 95% CI 1.18, 1.87), Hispanics (AOR 1.33, 95% CI 1.06, 1.65) and Medicaid patients (AOR 1.34, 95% CI 1.09, 1.64) were more likely to be readmitted.
Patients with high ADIs are more likely to experience short-term mortality after CABG surgery. African Americans, Hispanics, and Medicaid patients are more likely to experience 30-day readmissions. This information should be taken into account when monitoring patients to reduce adverse events following surgery, and more studies related to ADI are needed to fully understand its implications.
Metrics
Details
- Title
- The Association of Socioeconomic Factors With Outcomes for Coronary Artery Bypass Surgery
- Creators
- Edward L. Hannan - University at Albany, State University of New YorkYifeng Wu - University at Albany, State University of New YorkKimberly Cozzens - University at Albany, State University of New YorkMarcus Friedrich - New York State Department of Health, Albany, New YorkJoanna Chikwe - Cedars-Sinai Medical CenterDavid H. Adams - Mount Saint Vincent UniversityThoralf M. Sundt - Massachusetts General HospitalLeonard Girardi - Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New YorkCraig R. Smith - Presbyterian Medical CenterStephen J. Lahey - University of ConnecticutJeffrey P. Gold - University of Nebraska Medical CenterAndrew Wechsler - Drexel University
- Publication Details
- The Annals of thoracic surgery, v 114(4), pp 1318-1325
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; [Retired Faculty]
- Web of Science ID
- WOS:000861205700033
- Scopus ID
- 2-s2.0-85127827863
- Other Identifier
- 991020705463404721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery