Do Outcomes After Cardiac Surgery Differ by Preoperative Status and Socioeconomic Deprivation?

Preoperative cardiac surgical status (elective and urgent) and socioeconomic deprivation may have an impact on outcomes after cardiac surgery. We sought to examine differences in 30-day postoperative outcomes (resource utilization and mortality) by preoperative cardiac surgical status and socioeconomic deprivation and association of socioeconomic deprivation with 30-day outcomes.

Adults who underwent coronary artery bypass grafting or valve surgery at an urban medical center (January 1, 2019-December 31, 2023) were included in this study. Preoperative status was elective or urgent, with stratification into quartiles by level of socioeconomic deprivation within each cohort. Socioeconomic deprivation was measured by the Area Deprivation Index (ADI; score range, 1 [least deprivation] to 100 [most deprivation]). Analyses included multivariable regression modeling.

The elective cohort (n = 2419) had a mean age of 62 ± 12 years (70% male; 77% White); the urgent cohort (n = 603) had a mean age of 62 ± 13 years (70% male; 70% White). Median (interquartile range) hospital length of stay was longer in the urgent vs elective cohort (11 [8-18] days vs 4 [3-6] days; P < .001) and at higher ADI quartiles in both cohorts. Discharge to home was significantly less frequent and 30-day readmission was significantly more frequent in the urgent cohort. Discharge to home was significantly less frequent at higher ADI quartiles in the elective cohort. Thirty-day mortality differed by cohort (elective, 1.5%; urgent, 2.7%; P = .049) but not by ADI quartile. After adjustment for sociodemographic and clinical characteristics, a higher ADI quartile was significantly associated with discharge to a nonhome location in the elective cohort.

Understanding the effect of preoperative surgical status and socioeconomic deprivation on post-cardiac surgical outcomes provides actionable information to enhance patient care and to improve outcomes.