Abstract 17729: When Do Black and White Patients Die After Coronary Artery Bypass Surgery: Insights From the United States Veterans Health Administration
Karthik Raghunathan, Alex Bartholomew, Harold Wackerle, Marc Pepin, Atilio Barbeito, Tetsu Ohnuma, Julien Cobert, Eric JohnBull, Sachin Mehta, Negmeldeen Mamoun, Miriam Treggiari, Loreta Grecu, Vijay Krishnamoorthy, Karsten Bartels, WILLIAM E BRYAN- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Introduction: 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.
Hypothesis: 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.
Methods: 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.
Results: 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).
Conclusions: 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.