Outcomes of Indigenous Australians undergoing isolated coronary artery bypass graft surgery at a single institution

The 'gap' continues to exist between the Indigenous and non-Indigenous populations within Australia, with Indigenous Australians continuing to experience poorer health outcomes, and a reduced life expectancy of 10.6 years for males and 9.5 for females. Indigenous Australians are far more likely to suffer from ischaemic heart disease. We sought to investigate the outcomes of Indigenous Australians undergoing isolated coronary artery bypass graft surgery (CABG) at a single institution.

A retrospective cohort study comparing Indigenous with non-Indigenous Australians from prospectively collected data were performed for all patients who underwent isolated CABG at a single centre between 2015 and 2018. The primary endpoint was 30-day mortality with secondary endpoints including deep sternal wound infection, new renal failure, length of stay, stroke and rate of readmission.

A total of 905 patients were included in the study. The Indigenous cohort had 130 patients and the non-Indigenous cohort contained 775 patients. The baseline preoperative characteristics were significantly different between the two cohorts, with Indigenous patients younger (55.7 vs. 64.6 years), more likely to be female (33.1% vs. 16.4%) and to be dialysis-dependent (10% vs. 1.2%). The primary outcome was more likely in Indigenous Australians, with a 30-day mortality rate of 3.1% compared with 0.8%. There was a higher incidence of new renal failure (12.3% vs. 5.9%), red blood cell transfusion (30% vs. 20.8%).

Indigenous patients undergoing CABG at our institution have significantly more co-morbidities as well as worse post-operative outcomes and strategies to address this are urgently required.