Effects of race, with or without gender, on operative mortality after coronary artery bypass grafting: a study using The Society of Thoracic Surgeons National Database.
BACKGROUND
Although gender is known to be an independent predictor of 30-day operative mortality (OM) after coronary artery bypass grafting, the purpose of this study was to determine whether race-alone or in combination with gender-affects OM.


METHODS
For 1994 to 1996, The Society of Thoracic Surgeons database records for 441,542 coronary artery bypass grafting-only procedures were analyzed. Baseline annual multivariate models were built. Gender and race were added to each model. Risk-adjusted OM rates were then calculated for race, gender, and their combination. Patients were also stratified into groups of comparable predicted OM to allow for a direct comparison of risk-matched Caucasians and non-Caucasians.


RESULTS
Of the procedures, 28.2% were on women and 8.5% on non-Caucasians. Overall, OM was 3.29%. Multivariate risk-adjusted OM varied by gender and race (p < 0.10). Risk-adjusted OM rates (with 95% confidence intervals) were 4.0% (3.9% to 4.1%) for females and 3.2% (3.2% to 3.3%) for males. Risk-adjusted OM rates were 3.9% (3.7% to 4.1%) for non-Caucasians and 3.3% (3.2% to 3.3%) for Caucasians. Among equally risk-matched Caucasians and non-Caucasians, non-Caucasians had significantly higher (p < 0.005) mortality among the lower risk subgroups (up to 10% predicted OM) but not among the higher risk subgroups.


CONCLUSIONS
Race and gender are independent predictors of adverse outcome following coronary artery bypass grafting, holding all other risk factors constant.
Department of Surgery, Tulane University Medical School, New Orleans, Louisiana 70112, USA. rshartzmd@aol.com
R S
RS
Hartz
A V
AV
Rao
M E
ME
Plomondon
F L
FL
Grover
A L
AL
Shroyer
D000368:Aged; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000401:mortality*; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality*; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome