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Surgical Outcomes in Indigenous Peoples Undergoing Cardiac Surgery
Thomas Vierhout1, Morgan Nelson2, Meghana R K Helder3,4
1General Surgery Residency Program, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Introduction:
Heart disease is the leading cause of death in indigenous peoples, however cardiac surgical outcomes in this group are rarely studied. We hypothesized that complication rates in indigenous peoples undergoing cardiac surgery would be similar to Caucasians.
Methods:
From 2014 to 2020, 1,594 patients underwent cardiac surgery; 36 patients were identified as indigenous peoples. Risk factors, intraoperative, and postoperative variables were abstracted from our institution's database. We used the variables of age, BMI, diabetes, and tobacco use to propensity match the indigenous peoples to a group of Caucasian patients, 1:2, resulting in a total of 107 patients. Logistic regression analysis determined differences in complication rates.
Results:
Within the propensity-matched group, indigenous peoples were more likely to be in renal failure requiring dialysis (16.7 vs. 2.9 percent, p=0.02). Indigenous peoples had a 30-day mortality of 0 percent while Caucasians had a rate of 4.3 percent (p=0.55). Postoperative complication rates were lower in indigenous peoples (22.2 percent) compared to Caucasians (35.3 percent, p=0.17). Logistic multivariate regression analysis of complication rate did not yield race as a contributing variable (odds ratio 2.05; p=0.21).
Conclusions:
Following cardiac surgery, indigenous peoples had a mortality rate of 0 percent and a complication rate of 22 percent. Indigenous peoples had a clinically significant lower complication rate than Caucasians, and race did not play a statistically significant role in complication rates.
