The aim of this study was to evaluate whether African American, Hispanic, and Asian
patients in California were more likely to undergo coronary artery bypass grafting
(CABG) by cardiac surgeons with higher risk-adjusted mortality rates (RAMRs). Clinical
data from the California CABG Outcomes Reporting Program were analyzed for all patients
who underwent isolated CABG from 2003 to 2006 by surgeons who performed ≥10 operations.
Surgeons were divided into quintiles on the basis of their RAMRs, with the top-performing
surgeons in the first quintile and the lowest performing surgeons in the fifth quintile.
There were 72,845 isolated CABG procedures performed by 303 surgeons, including 49,886
in white, 9,380 in Hispanic, 6,867 in Asian, and 2,750 in African American patients.
African American and Asian patients underwent CABG by surgeons with higher mean RAMRs
(2.90% and 2.99%, respectively) compared with the state average of 2.65% (p <0.001).
Compared to white patients, Asian and Hispanic patients were more likely to be treated
by surgeons in the lowest quintile (odds ratio [OR] 1.2, 95% confidence interval [CI]
1.11 to 1.3, and OR 1.38, 95% CI 1.30 to 1.48, respectively). African Americans and
Hispanics were less likely to be operated on by surgeons in the top quintile compared
to white patients (OR 0.80, 95% CI 0.71 to 0.90, and OR 0.81, 95% CI 0.76 to 0.87,
respectively). Hispanics were less likely to be treated by surgeons in the top quintile
than by surgeons in the lowest quintile (OR 0.65, 95% CI 0.60 to 0.75). In conclusion,
racial and ethnic minority patients who undergo isolated CABG in California may be
more likely to be operated on by cardiac surgeons with higher RAMRs.
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Article Info
Publication History
Accepted:
August 21,
2010
Received in revised form:
August 21,
2010
Received:
June 16,
2010
Footnotes
Dr. Castellanos was funded by the Division of Cardiovascular Medicine, University of California, Davis Medical Center , Sacramento, California, and the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy , Boston, Massachusetts.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
