Socio-economic status and early outcome from coronary artery bypass grafting.
OBJECTIVE
To determine the effects of socio-economic status (SES) on the outcome of coronary artery bypass grafting (CABG).


METHODS
Prospective cohort study.


METHODS
Regional cardiac surgical unit.


METHODS
1994 consecutive patients undergoing non-emergency CABG.


METHODS
SES was determined from the patient's postcode using Carstairs tables. The primary end-point was all-cause mortality at 30 days.


RESULTS
There were 50 deaths (2.5%) within 30 days of surgery. A higher Carstairs score demonstrated a trend towards increased 30-day mortality (odds ratio (OR) 1.09 per unit, 95% CI 1.00 to 1.20, p = 0.06). In a backward conditional model, including other predictors of early mortality, Carstairs scores were independently predictive (OR 1.12 per unit, 95% CI 1.01 to 1.24, p = 0.02). In a model including only Carstairs scores and the EuroSCORE, both were independent predictors of this outcome (OR for Carstairs score 1.11 per unit, 95% CI 1.00 to 1.22, p = 0.04). The 30-day mortality increases in each quartile of Carstairs scores, with patients in quartile 4 (most deprived) at significantly higher risk compared with quartile 1 (uncorrected OR 2.53 per unit, 95% CI 1.04 to 6.15; OR corrected for EuroSCORE, 2.56 per unit, 95% CI 1.03 to 6.34, p = 0.04 for both). Similarly, patients in the least affluent quartile were twice as likely to suffer a serious complication as those in the most affluent quartile (OR 2.14 per unit, 95% CI 1.32 to 3.46, p = 0.002). This increased risk was also independent of the EuroSCORE.


CONCLUSIONS
Lower SES is associated with a poorer early outcome following CABG and is independent of other recognised risk factors.
Gibson
P H
PH
Department of Cardiology, University of Aberdeen and Aberdeen Royal Infirmary, Aberdeen, UK.
Croal
B L
BL
Cuthbertson
B H
BH
Gibson
G
G
Jeffrey
R R
RR
Buchan
K G
KG
El-Shafei
H
H
Hillis
G S
GS
D000368:Aged; D001026:Coronary Artery Bypass / Q000191:economics / Q000401:mortality*; D003327:Coronary Disease / Q000191:economics / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016896:Treatment Outcome