Minorities May Be Operated on by Lower-Performing Surgeons

African-American, Asian CABG patients may have surgeons with higher risk-adjusted mortality rates

WEDNESDAY, Jan. 5 (HealthDay News) -- Minority patients undergoing isolated coronary artery bypass grafting (CABG) are more likely to be operated on by cardiac surgeons with higher risk-adjusted mortality rates (RAMRs), according to a study published in the January issue of the American Journal of Cardiology.

Luis R. Castellanos, M.D., M.P.H., of the University of California Davis Medical Center in Sacramento, and colleagues analyzed 72,845 isolated CABG procedures that were performed between 2003 and 2006 in California by 303 surgeons. The surgeons were divided into quintiles on the basis of their RAMRs, with the top-performing surgeons in the first quintile and the lowest in the fifth.

The researchers found that the Asian and African-American patients underwent CABG procedures by surgeons with higher mean RAMRs, 2.99 and 2.90 percent, respectively, compared with the state average of 2.65 percent. The mean RAMR for white patients was 2.58 percent, and for Hispanic patients it was 2.55 percent. Compared to white patients, African-American and Hispanic patients were less likely to be treated by surgeons in the highest performance group (odds ratios, 0.80 and 0.81, respectively), and Asians and Hispanics were more likely to be treated by surgeons in the lowest performance group (odds ratios, 1.2 and 1.38, respectively).

"Even after adjusting for comorbid illnesses and demographic characteristics, African-American and Asian patients were more likely to be operated on by cardiac surgeons with lower operative performance," the authors write.

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