Examining patient demographics and major adverse cardiac events following noncardiac surgery: Applying a health equity lens.

Autor: Herrera-Quiroz D; Mayo Clinic Alix School of Medicine, Mayo Clinic, Phoenix, AZ 85054, USA., Smith BB; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85054, USA., Dodoo C; Department of Quantitative Health Sciences, Mayo Clinic; Phoenix, AZ 85054, USA., Brown MJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA., Hayes SN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Milam AJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85054, USA; Department of Quantitative Health Sciences, Mayo Clinic; Phoenix, AZ 85054, USA. Electronic address: milam.adam@mayo.edu.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2024 Nov; Vol. 68, pp. 62-70. Date of Electronic Publication: 2024 Jun 10.
DOI: 10.1016/j.carrev.2024.06.004
Abstrakt: Background: Major adverse cardiac events (MACE) are a major contributor to postoperative complications. This study employed a health equity lens to examine rates of postoperative MACE by race and ethnicity.
Methods: This single-center, retrospective observational cohort study followed patients with and without pre-existing coronary artery stents from 2008 to 2018 who underwent non-cardiac surgery. MACE was the primary outcome (death, acute MI, repeated coronary revascularization, in-stent thrombosis) and self-reported race and ethnicity was the primary predictor. A propensity score model of a 1:1 cohort of non-Hispanic White (NHW) patients and all other racial and ethnic minority populations (Hispanic and Black) was used to compare the rate of perioperative MACE in this cohort.
Results: During the study period, 79,686 cases were included in the analytic sample; 950 patients (1.2 %) had pre-existing coronary artery stents. <1 % of patients experienced MACE within 30 days following non-cardiac surgery (0.8 %). After confounder adjustment and propensity score matching, there were no statistically significant differences in MACE among racial and ethnic minority patients compared to NHW patients (OR = 0.77; 95 % CI: 0.48, 1.25). In our sensitivity analyses, stratifying by sex, there were no differences in MACE by race and ethnicity.
Conclusions: The study found no statistically significant differences in MACE by race and ethnicity among patients who underwent non-cardiac surgery. Access to a high-volume, high-quality hospital such as the one studied may reduce the presence of healthcare disparities and may explain why our findings are not consistent with previous studies.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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