Racial Disparities in ICU Admission Rate Post-Coronary Artery Bypass Graft and Appendectomy Surgery

Intensive care unit (ICU) admissions are the standard of care (SOC) for coronary artery bypass graft (CABG) and are reserved for highly complicated appendectomy cases. Therefore, they are uniquely positioned to examine racial disparities in the likelihood of receiving SOC and suffering complications. Using a US national database, we studied Black or White adults (≥18 years old) undergoing emergent, urgent, or elective inpatient CABG or appendectomy. The primary outcome was ICU admission stratified by procedure and was measured using mixed-effects models. A sensitivity analysis controlled for hospital. Black patients had higher odds of ICU admission post-CABG (OR 1.35 95% CI 1.27-1.42, P < 0.001) and post-appendectomy (OR 1.11 95% CI 1.05-1.17, P < 0.001). However, no significant racial disparities were observed in our sensitivity analysis. This shows that while racial disparities exist due to cultural, disease-related, and socioeconomic reasons, these may be driven by hospital-related variability, likely in familiarity with the patients' different needs, and not provider-level bias.