Blacks Have Off-Pump CABG with Low-Volume Surgeons
Racial disparities seen in off-pump coronary artery bypass grafting
THURSDAY, Jan. 18 (HealthDay News) -- Surgeons who lack experience with off-pump coronary artery bypass grafting (CABG) may be more likely to use the technique on black patients than on white patients, according to study findings published in the January issue of the Journal of Health Services Research & Policy.
Dana Mukamel, Ph.D., of the University of California at Irvine, and colleagues examined 15,313 CABG patients from New York. The investigators found that 31 percent of black and 23 percent of white CABG patients underwent off-pump surgery.
The higher rates seen among black patients stemmed from surgeons who perform fewer off-pump procedures. Specifically, black patients treated by low-volume surgeons were 1.9 times more likely to have off-pump surgery compared with white patients treated by the same surgeons. No differences were seen between black and white patients treated by high-volume surgeons.
The new findings may not be due to overt racism, note Artyom Sedrakyan, M.D., Ph.D., of the Agency for Healthcare Research and Quality in Rockville, Md., and Tom Treasure, M.D., of Guy's Hospital in London, U.K., in an accompanying editorial. "The take up of off-pump surgery was perhaps earlier in New York City with its large population of blacks and the concentration of teaching institutions and, therefore, of trainees, who would feature as low-volume surgeons in New York State data."