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Int. J. Environ. Res. Public Health 2013, 10(9), 4175-4185; doi:10.3390/ijerph10094175
Article

Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting

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1 Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA 3 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA 4 Department of Internal of Medicine, Division of Nephrology and Hypertension, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA 5 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA 6 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 / Revised: 28 August 2013 / Accepted: 30 August 2013 / Published: 6 September 2013
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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 dialysis; mortality; paradox; disparities; heart disease
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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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.

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