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Racial differences in survival among hemodialysis patients after coronary artery bypass grafting

Jimmy T Efird1, Wesley T O'Neal, Paul Bolin

  • 1Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org

International Journal of Environmental Research and Public Health
|September 11, 2013
PubMed

Insights

White hemodialysis patients undergoing coronary artery bypass grafting (CABG) had significantly lower long-term survival rates compared to Black patients. This study highlights crucial racial disparities in outcomes for this vulnerable patient group.

Area of Science:

  • Cardiology
  • Nephrology
  • Health Services Research

Background:

  • Coronary artery bypass grafting (CABG) is a major surgical procedure.
  • Patients on hemodialysis represent a high-risk population for adverse surgical outcomes.
  • Racial differences in long-term survival after CABG among hemodialysis patients are not well-established.

Purpose of the Study:

  • To investigate racial disparities in long-term survival following coronary artery bypass grafting (CABG) in patients undergoing maintenance hemodialysis.
  • To compare survival probabilities between Black and White hemodialysis patients post-CABG.
  • To provide evidence-based information for clinicians managing this patient population.

Main Methods:

  • Retrospective cohort study comparing Black and White hemodialysis patients undergoing first-time, isolated CABG between 1992 and 2011.
  • Kaplan-Meier product-limit method used for survival probability computation, stratified by race.
  • Cox regression models employed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for survival outcomes.

Main Results:

  • A total of 207 hemodialysis patients (2%) underwent CABG during the study period.
  • White hemodialysis patients (n=80) demonstrated significantly decreased 5-year survival compared to Black hemodialysis patients (n=127).
  • The adjusted hazard ratio for 5-year mortality in White patients was 1.9 (95% CI: 1.2-2.8).

Conclusions:

  • Significant racial differences exist in long-term survival after CABG among hemodialysis patients.
  • White hemodialysis patients face a higher risk of mortality post-CABG compared to their Black counterparts.
  • Findings underscore the need for targeted interventions and further research to address these survival disparities.

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