Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor

Mohammad F Babgi1, Haitham M Albar2, Mohammed H Miny1

  • 1Department of Cardiac Surgery, King Abdullah Medical City, Makkah 57657, Saudi Arabia.

Insights

This study found no significant differences in cardiac surgery outcomes or survival rates between Saudi and non-Saudi patients undergoing coronary artery bypass grafting (CABG). Underlying health conditions, not nationality, were associated with patient outcomes.

Area of Science:

  • Cardiology
  • Health Services Research
  • Surgical Outcomes

Background:

  • Health disparities based on gender, socioeconomic status, and ethnicity are well-documented globally.
  • Saudi Arabia's diverse population, especially during pilgrimage, presents unique challenges for equitable cardiac healthcare delivery.
  • Previous research highlights excess mortality and illness burdens in minority populations, necessitating studies on healthcare equity.

Purpose of the Study:

  • To investigate potential disparities in cardiac surgical outcomes after isolated coronary artery bypass grafting (CABG) between Saudi and non-Saudi patients.
  • To assess whether nationality influences mortality and postoperative complications in patients undergoing CABG surgery.
  • To identify factors associated with cardiac surgical outcomes in a diverse patient population.

Main Methods:

  • Retrospective analysis of 2178 patients undergoing isolated CABG at King Abdullah Medical City (December 2014 - July 2020).
  • Data collected included demographics, clinical features, comorbidities, diagnoses, surgical procedures, complications, length of hospital stay, and mortality.
  • Primary outcome was in-hospital mortality following CABG surgery.

Main Results:

  • The study included 57.5% Saudi and 42.5% non-Saudi patients; 72.7% were male.
  • Mortality rates were statistically similar between Saudi (5%) and non-Saudi (5.3%) patients (p < 0.786).
  • Postoperative complications were comparable, with the exception of extracorporeal membrane oxygenation (ECMO) use.

Conclusions:

  • Nationality alone was not a significant predictor of survival or postoperative outcomes in isolated CABG surgery.
  • Underlying comorbidities, rather than patient nationality, were identified as the key determinant of cardiac surgical outcomes.
  • These findings suggest that equitable care is being provided, with outcomes primarily driven by individual health status.

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