Relation of Race, Ethnicity and Cardiac Surgeons to Operative Mortality Rates in Primary Coronary Artery Bypass Grafting in California
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 Reporti...
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| Veröffentlicht in: | The American journal of cardiology 2011, Vol.107 (1), p.1-5 |
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| container_title | The American journal of cardiology |
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| creator | Castellanos, Luis R., MD, MPH Li, Zhongmin, PhD Yeo, Khung Keong, MBBS Young, J. Nilas, MD Ayanian, John Z., MD, MPP Amsterdam, Ezra A., MD |
| description | 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 |
| doi_str_mv | 10.1016/j.amjcard.2010.08.036 |
| format | Article |
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Nilas, MD ; Ayanian, John Z., MD, MPP ; Amsterdam, Ezra A., MD</creator><creatorcontrib>Castellanos, Luis R., MD, MPH ; Li, Zhongmin, PhD ; Yeo, Khung Keong, MBBS ; Young, J. Nilas, MD ; Ayanian, John Z., MD, MPP ; Amsterdam, Ezra A., MD</creatorcontrib><description>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.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.08.036</identifier><identifier>PMID: 21146677</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>African Americans ; Aged ; Asian Americans ; Biological and medical sciences ; California - ethnology ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Coronary Artery Bypass - mortality ; Coronary Artery Disease - ethnology ; Coronary Artery Disease - surgery ; Coronary heart disease ; Ethnic Groups ; Ethnicity ; Female ; Heart ; Heart surgery ; Hispanic Americans ; Humans ; Male ; Medical sciences ; Middle Aged ; Physicians - standards ; Race ; Surgeons ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The American journal of cardiology, 2011, Vol.107 (1), p.1-5</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Jan 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-d765bc4ed6de2de6ff1f0660a82ccecc16e9c272c2167f79102ccc1be426664c3</citedby><cites>FETCH-LOGICAL-c476t-d765bc4ed6de2de6ff1f0660a82ccecc16e9c272c2167f79102ccc1be426664c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2010.08.036$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23960459$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21146677$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castellanos, Luis R., MD, MPH</creatorcontrib><creatorcontrib>Li, Zhongmin, PhD</creatorcontrib><creatorcontrib>Yeo, Khung Keong, MBBS</creatorcontrib><creatorcontrib>Young, J. Nilas, MD</creatorcontrib><creatorcontrib>Ayanian, John Z., MD, MPP</creatorcontrib><creatorcontrib>Amsterdam, Ezra A., MD</creatorcontrib><title>Relation of Race, Ethnicity and Cardiac Surgeons to Operative Mortality Rates in Primary Coronary Artery Bypass Grafting in California</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>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.</description><subject>African Americans</subject><subject>Aged</subject><subject>Asian Americans</subject><subject>Biological and medical sciences</subject><subject>California - ethnology</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Coronary Artery Disease - ethnology</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary heart disease</subject><subject>Ethnic Groups</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Hispanic Americans</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Physicians - standards</subject><subject>Race</subject><subject>Surgeons</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksFuEzEQhlcIREvhEUAWEuJCgse7sdeXohKVglRUlMLZcmZni8PGDrZTKS_Ac-MloUi9cLI9-ub3zPxTVc-BT4GDfLua2vUKbeymgpcYb6e8lg-qY2iVnoCG-mF1zDkXEw2NPqqepLQqT4CZfFwdCYBGSqWOq18LGmx2wbPQs4VFesPO83fv0OUds75j8_KFs8iut_GGgk8sB3a1oViSbol9DjHbYWQXNlNizrMv0a1t3LF5iMGPl7OYqRzvdxubEruIts_O34zovKT2IXpnn1aPejskenY4T6pvH86_zj9OLq8uPs3PLifYKJknnZKzJTbUyY5ER7LvoedSctsKREIESRqFEihAql5p4CWOsKRGSCkbrE-q13vdTQw_t5SyWbuENAzWU9gm05bJaNHWspAv75GrsI2-FGda0IrLRqgCzfYQxpBSpN5s9t0b4Ga0yazMwSYz2mR4a_gf8RcH8e1yTd1d1l9fCvDqANiEduij9ejSP67WkjczXbh3e47K0G4dRZPQkUfqXCTMpgvuv6Wc3lPAwRX_7fCDdpTumgaThOHmetypcaWgLJMC3dS_AY-ryPs</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>Castellanos, Luis R., MD, MPH</creator><creator>Li, Zhongmin, PhD</creator><creator>Yeo, Khung Keong, MBBS</creator><creator>Young, J. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Coronary Artery Disease - ethnology</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary heart disease</topic><topic>Ethnic Groups</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Hispanic Americans</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Physicians - standards</topic><topic>Race</topic><topic>Surgeons</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castellanos, Luis R., MD, MPH</creatorcontrib><creatorcontrib>Li, Zhongmin, PhD</creatorcontrib><creatorcontrib>Yeo, Khung Keong, MBBS</creatorcontrib><creatorcontrib>Young, J. Nilas, MD</creatorcontrib><creatorcontrib>Ayanian, John Z., MD, MPP</creatorcontrib><creatorcontrib>Amsterdam, Ezra A., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castellanos, Luis R., MD, MPH</au><au>Li, Zhongmin, PhD</au><au>Yeo, Khung Keong, MBBS</au><au>Young, J. Nilas, MD</au><au>Ayanian, John Z., MD, MPP</au><au>Amsterdam, Ezra A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of Race, Ethnicity and Cardiac Surgeons to Operative Mortality Rates in Primary Coronary Artery Bypass Grafting in California</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2011</date><risdate>2011</risdate><volume>107</volume><issue>1</issue><spage>1</spage><epage>5</epage><pages>1-5</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21146677</pmid><doi>10.1016/j.amjcard.2010.08.036</doi><tpages>5</tpages></addata></record> |
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| subjects | African Americans Aged Asian Americans Biological and medical sciences California - ethnology Cardiology Cardiology. Vascular system Cardiovascular Coronary Artery Bypass - mortality Coronary Artery Disease - ethnology Coronary Artery Disease - surgery Coronary heart disease Ethnic Groups Ethnicity Female Heart Heart surgery Hispanic Americans Humans Male Medical sciences Middle Aged Physicians - standards Race Surgeons Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Relation of Race, Ethnicity and Cardiac Surgeons to Operative Mortality Rates in Primary Coronary Artery Bypass Grafting in California |
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