Related Experiment Video
Updated: Jul 21, 2025

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
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.
Abstract:
(1) Background: Disparity in clinical care on the basis of gender, socioeconomic status, ethnic and racial variation is an established phenomenon. The focus on health disparities was led on by the report of the Secretary's Task Force on Black & Minority Health, which emphasized that the burden of death and illness was in excess among black people and other minorities. In Saudi Arabia, cardiac health care is being provided to a heterogeneous group of patients during pilgrimage time. This mixed population comprises different socio-economic backgrounds, demographics, ethnicities and languages. This study was carried out to assess for any disparities in cardiac surgical outcomes after isolated CABG surgery between Saudi citizens and non-Saudi patients. (2) Methods: The data of 2178 patients who underwent isolated coronary artery bypass surgery at King Abdullah Medical City from December 2014 to July 2020 were extracted. Patient demographics, clinical features, comorbidities, diagnoses, surgical procedures, complications, length of hospital stay and mortality were included in the data. The primary outcome was mortality after coronary artery bypass grafting surgery. (3) Results: A total of 2178 isolated CABG procedures were conducted during the study period with almost 57.5% of patients being Saudi citizens in comparison with 42.5% of non-Saudi citizens. The male gender represented the majority of the population, with a total of 1584 patients, representing 72.7% of the total study population. The rate of mortality had no statistical significance with the mortality rate of 5% vs. 5.3% (p < 0.786). The postoperative morbidities were comparable for all the parameters except for postoperative extracorporeal membrane oxygenation (ECMO). (4) Conclusions: In the present study, the chances of survival and postoperative outcomes are not associated with nationality per se, but with underlying comorbidities.
More Related Videos
Related Concept Videos
Cardiac Catheterization I: Pre-Procedure Overview
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Coronary Artery Disease V: Interprofessional Care

