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Updated: Apr 30, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Intra-aortic Balloon Pump Utilization Prior to Coronary Artery Bypass Grafting: Social Determinants of Health
Abdul Rasheed Bahar1, Yasemin Bahar1, Hafeezuddin Ahmed2
1Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan.
Insights
This study found significant disparities in the use of intra-aortic balloon pumps (IABP) before coronary artery bypass graft (CABG) surgery. Women and patients in certain regions received less IABP support, highlighting inequities in cardiovascular care.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Health Equity
Background:
- Disparities in healthcare access and utilization are prevalent in cardiovascular interventions.
- Intra-aortic balloon pump (IABP) use in high-risk coronary artery bypass graft (CABG) patients varies significantly across demographic groups.
- Social determinants of health may influence IABP utilization prior to CABG.
Purpose of the Study:
- To examine the influence of social determinants of health on IABP utilization before CABG.
- To investigate disparities related to sex, race, ethnicity, income, and insurance status in IABP use.
Main Methods:
- Retrospective cohort study using the Nationwide Inpatient Sample (2016-2021).
- Identified CABG patients with preoperative IABP use.
- Multivariable logistic regression and propensity score matching analyzed sociodemographic factors and outcomes.
Main Results:
- IABP was used preoperatively in 3.1% of 471,985 CABG patients.
- Women and patients in the South/West regions had lower IABP use; Hispanic and Asian patients had higher use compared to Whites.
- Medicaid coverage was associated with increased IABP use; income and weekend admissions showed varied associations.
Conclusions:
- Significant sociodemographic and regional disparities exist in IABP utilization.
- Sex-based disparities and racial/ethnic variations in IABP use require further investigation.
- Targeted interventions are needed to ensure equitable access to advanced cardiovascular therapies.
Background:
Disparities in health care access and utilization have been widely documented in cardiovascular interventions. The intra-aortic balloon pump (IABP), a critical mechanical circulatory device used in high-risk coronary artery bypass graft (CABG) patients, has shown significant variability in utilization across sociodemographic groups. This study examines the influence of social determinants of health, including sex, race, ethnicity, income, and insurance status, on IABP utilization prior to CABG.
Methods:
This retrospective cohort study utilized the Nationwide Inpatient Sample from 2016-2021 to identify patients undergoing CABG. IABP use was defined as preoperative utilization in patients awaiting CABG. Multivariable logistic regression analyzed the impact of sociodemographic factors on IABP use, adjusting for baseline comorbidities and hospital characteristics. Propensity score matching was employed to compare in-hospital outcomes between IABP and non-IABP groups. Statistical significance was set at P < .05.
Results:
Of 471,985 CABG patients, IABP was utilized in 14,535 patients (3.1%) preoperatively. Adjusted analyses revealed significant disparities: women were less likely to receive IABP, while Hispanic and Asian patients were more likely to receive IABP compared to Whites. Medicaid coverage increased the odds of IABP use, whereas income quartiles showed no significant impact. Regional disparities were noted, with lower odds of IABP use in the South and West. Weekend admissions were associated with higher IABP utilization. Subgroup analysis identified higher IABP use among Hispanic men and women.
Conclusions:
Significant disparities in IABP utilization exist across sociodemographic and regional lines, with lower use among women and patients in the South and West regions, and higher use among Hispanic and Asian patients. These findings underscore the presence of sex-based disparities and significant variation in racial/ethnic patterns of IABP utilization, highlighting the need for further investigation and targeted interventions to ensure equitable application of advanced cardiovascular therapies.
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