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Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting
Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
Department of Internal of Medicine, Division of Nephrology and Hypertension, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
These authors contributed equally to this work.
* Author to whom correspondence should be addressed.
Received: 22 July 2013; in revised form: 28 August 2013 / Accepted: 30 August 2013 / Published: 6 September 2013
Abstract: The aim of this study was to examine racial differences in long-term survival among hemodialysis patients after coronary artery bypass grafting (CABG). To our knowledge this has not been previously addressed in the literature. Black and white hemodialysis patients undergoing first-time, isolated CABG procedures between 1992 and 2011 were compared. Survival probabilities were computed using the Kaplan-Meier product-limit method and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. A total of 207 (2%) patients were on hemodialysis at the time of CABG. White (n = 80) hemodialysis patients had significantly decreased 5-year survival compared with black (n = 127) patients (adjusted HR = 1.9, 95% CI = 1.2–2.8). Our finding provides useful outcome information for surgeons, primary care providers, and their patients.
Keywords: dialysis; mortality; paradox; disparities; heart disease
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Efird, J.T.; O'Neal, W.T.; Bolin, P., Jr.; Davies, S.W.; O'Neal, J.B.; Anderson, C.A.; Ferguson, T.B.; Chitwood, W.R.; Kypson, A.P. Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting. Int. J. Environ. Res. Public Health 2013, 10, 4175-4185.
Efird JT, O'Neal WT, Bolin P, Jr, Davies SW, O'Neal JB, Anderson CA, Ferguson TB, Chitwood WR, Kypson AP. Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting. International Journal of Environmental Research and Public Health. 2013; 10(9):4175-4185.
Efird, Jimmy T.; O'Neal, Wesley T.; Bolin, Paul, Jr.; Davies, Stephen W.; O'Neal, Jason B.; Anderson, Curtis A.; Ferguson, T. B.; Chitwood, W. R.; Kypson, Alan P. 2013. "Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting." Int. J. Environ. Res. Public Health 10, no. 9: 4175-4185.