Abstract 17729: When Do Black and White Patients Die After Coronary Artery Bypass Surgery: Insights From the United States Veterans Health Administration
Raghunathan, K; Bartholomew, A; Wackerle, H; Pepin, M; Barbeito, A; Ohnuma, T; Cobert, J; JohnBull, E; Mehta, S; Mamoun, N; Treggiari, M ...
Published in: Circulation
Black patients continue to have disproportionately higher rates of death after Coronary Artery Bypass Graft (CABG) procedures. Data are needed to guide interventions to eliminate inequity. We examine race-related differences in when death occurred after CABG by comparing the proportions of 1-yr mortality occurring within versus after the first 30-days.
When compared with White patients, 1-yr mortality after isolated CABG among Black patients is significantly more likely to occur within the first 30-days postoperatively.
Using comprehensive death ascertainment files in the most extensive integrated health system in the US, the Veterans Health Administration (VHA), we extracted 30-day and 1-year mortality data after isolated CABG (defined using procedural codes) between January 2006 and December 2015 (follow-up through to December 2016). We classified patients as non-Hispanic Black versus White. We compare 1-yr mortality and the proportions of 1-yr mortality occurring within the first 30-days. We examine trends over the 10-year period.
Among 14743 White versus 1545 Black veterans who underwent isolated CABG over the 10-year period, 589 versus 85 had died within 1-yr (4% versus 5.5% respectively, p<0.05). The proportions who died within the first 30-days was significantly lower among White when compared with Black veterans, 31.7% versus 36.5%, p<0.05. Over the 10-year period, the difference between races in when patients died grew substantially (Figure) whereas race-related differences in 1-yr mortality decreased (Figure).
While racial disparities in death after CABG are well known, we present the first study showing differences in when death occurs within 1-yr. Using accurate nationwide data, we found that Black patients who died within 1-yr after isolated CABG increasingly died within the first 30-days.
