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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) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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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