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Title: Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: insights from a multicentre registry.
Austin Authors: Shi, William Y;Yap, Cheng-Hon;Newcomb, Andrew E;Hayward, Philip A R;Tran, Lavinia;Reid, Christopher M;Smith, Julian A
Affiliation: Department of Cardiothoracic Surgery, Geelong Hospital, Australia
Department of Cardiothoracic Surgery, Monash Health, and Department of Surgery (MMC), Monash University, Melbourne, Australia
Department of Cardiac Surgery, Austin Hospital, Melbourne, Australia
Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Australia
Cardiovascular Research Centre, St Vincent's Hospital, Melbourne, Australia
Issue Date: 28-Feb-2014
Publication information: Heart, Lung & Circulation 2014; 23(8): 726-36
Abstract: We examined whether socioeconomic status and rurality influenced outcomes after coronary surgery.We identified 14,150 patients undergoing isolated coronary surgery. Socioeconomic and rurality data was obtained from the Australian Bureau of Statistics and linked to patients' postcodes. Outcomes were compared between categories of socioeconomic disadvantage (highest versus lowest quintiles, n= 3150 vs. 2469) and rurality (major cities vs. remote, n=9598 vs. 839).Patients from socioeconomically-disadvantaged areas experienced a greater burden of cardiovascular risk factors including diabetes, obesity and current smoking. Thirty-day mortality (disadvantaged 1.6% vs. advantaged 1.6%, p>0.99) was similar between groups as was late survival (7 years: 83±0.9% vs. 84±1.0%, p=0.79). Those from major cities were less likely to undergo urgent surgery. There was similar 30-day mortality (major cities: 1.6% vs. remote: 1.5%, p=0.89). Patients from major cities experienced improved survival at seven years (84±0.5% vs. 79±2.0%, p=0.010). Propensity-analysis did not show socioeconomic status or rurality to be associated with late outcomes.Patients presenting for coronary artery surgery from different socioeconomic and geographic backgrounds exhibit differences in their clinical profile. Patients from more rural and remote areas appear to experience poorer long-term survival, though this may be partially driven by the population's clinical profile.
Gov't Doc #: 24657281
DOI: 10.1016/j.hlc.2014.02.008
Type: Journal Article
Subjects: Coronary artery bypass
Coronary artery disease
Socioeconomic disadvantage
Aged, 80 and over
Coronary Artery Bypass
Coronary Artery
Disease-Free Survival
Middle Aged
Retrospective Studies
Rural Population
Socioeconomic Factors
Survival Rate
Urban Population
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