Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Saudi (n = 1252) | Non-Saudi (n = 926) | Total (N = 2178) | p-Value | |
---|---|---|---|---|---|
Socio-demographic characteristics | |||||
Gender | Male | 869 (69.4%) | 715 (77.2%) | 1584 (72.7%) | <0.001 |
Female | 383 (30.6%) | 211 (22.8%) | 594 (27.3%) | ||
Age | 55.4 ± 12.9 | 55.8 ± 11.6 | 55.5 ± 12.4 | 0.430 | |
Weight | 74.4 ± 15.7 | 74.3 ± 15.0 | 74.3 ± 15.4 | 0.940 | |
Euroscore II | 2.6 (2.1–4.1) | 2.6 (2.1–4.3) | 2.6 (2.1–4.1) | 0.891 | |
Ejection fraction (EF) | 45.2 ±10.4 | 44.8 ± 10.3 | 45.05 ± 10.4 | 0.952 | |
Smoker | 493 (39.4%) | 298 (32.2%) | 791 (36.3%) | 0.001 | |
New York Heart Association (NYHA) Classification | |||||
I | 9 (0.7%) | 5 (0.5%) | 14 (0.6%) | 0.090 | |
II | 786 (62.8%) | 630 (68.0%) | 1416 (65.0%) | ||
III | 383 (30.6%) | 234 (25.3%) | 617 (28.3%) | ||
IV | 65 (5.2%) | 46 (5.0%) | 111 (5.1%) | ||
Comorbidities | |||||
Dyslipidemia | 138 (11.0%) | 86 (9.3%) | 224 (10.3%) | 0.188 | |
Obesity | 281 (22.4%) | 205 (22.1%) | 486 (22.3%) | 0.865 | |
Diabetes mellitus | 820 (65.5%) | 528 (57.0%) | 1348 (61.9%) | 0.000 | |
Hypertension | 849 (67.8%) | 609 (65.8%) | 1458 (66.9%) | 0.316 | |
Cerebrovascular accident | 78 (6.2%) | 34 (3.7%) | 112 (5.1%) | 0.008 | |
Peripheral vascular disease | 29 (2.3%) | 10 (1.1%) | 39 (1.8%) | 0.031 | |
Carotid disease | 19 (1.5%) | 14 (1.5%) | 33 (1.5%) | 0.991 | |
Chronic obstructive pulmonary disease | 58 (4.6%) | 32 (3.5%) | 90 (4.1%) | 0.173 | |
Operative techniques | |||||
CABG on pump | Yes | 1305 (95.9%) | 56 (4.1%) | 1361 (100%) | 0.029 |
No | 761 (93.1%) | 56 (6.9%) | 817 (100%) | ||
Total | 2066 (94.9%) | 112 (5.1%) | 2178 (100%) | ||
CABG off pump | Yes | 22 (100%) | 0 (0.0%) | 22 (100%) | 0.251 |
No | 2044 (94.8%) | 112 (5.2%) | 2156 (100%) | ||
Total | 2066 (94.9%) | 112 (5.1%) | 2178 (100%) | ||
Nature of the operation | |||||
Elective | 1122 (89.6%) | 771 (83.3%) | 1893 (87%) | <0.001 | |
Urgent | 5 (0.4%) | 5 (0.5%) | 10 (0.5%) | ||
Emergency | 123 (9.8%) | 150 (16.2%) | 273 (12.5%) |
Postoperative Mortality and Morbidities | Saudi | Non-Saudi | Total | p-Value |
---|---|---|---|---|
In-hospital mortality | 63 (5.0%) | 49 (5.3) | 112 (5.1%) | 0.786 |
Morbidities | ||||
Prolonged ventilation | 101 (8.1%) | 77 (8.3%) | 178 (8.2%) | 0.834 |
Reintubation | 47 (3.8%) | 31 (3.3%) | 78 (3.6%) | 0.614 |
New postoperative atrial fibrillation (AF) | 236 (18.8%) | 166 (17.9%) | 402 (18.5%) | 0.583 |
Re-exploration | 66 (5.3%) | 52 (5.6%) | 118 (5.4%) | 0.721 |
Acute kidney injury | 64 (5.1%) | 54 (5.8%) | 118 (5.4%) | 0.463 |
Continuous renal replacement therapy | 64 (5.1%) | 45 (4.9%) | 109 (5.0%) | 0.790 |
Postoperative cerebrovascular accident (CVA) | 30 (2.4%) | 16 (1.7%) | 46 (2.1%) | 0.284 |
Perioperative myocardial infarction (MI) | 2 (0.2%) | 2 (0.2%) | 4 (0.2%) | 0.762 |
Sepsis | 73 (5.8%) | 49 (5.3%) | 122 (5.6%) | 0.589 |
Mediastinitis | 5 (0.4%) | 4 (0.4%) | 9 (0.4%) | 0.907 |
Postoperative intra-aortic balloon pump (IABP) | 79 (6.3%) | 75 (8.1%) | 154 (7.1%) | 0.107 |
Postoperative ECMO | 12 (1.0%) | 19 (2.1%) | 31 (1.4%) | 0.033 |
Characteristics | Alive (n = 2066) | Dead (n = 112) | Total (N = 2178) | p-Value | |
---|---|---|---|---|---|
Socio-demographic characteristics | |||||
Gender | Male | 1514 (95.6%) | 70 (4.4%) | 1584 (100%) | 0.013 |
Female | 552 (92.9%) | 42 (7.1%) | 594 (100%) | ||
Nationality | Saudi | 1189 (95.0%) | 63 (5.0%) | 1252 (100%) | 0.786 |
Non-Saudi | 877 (94.7%) | 49 (5.3%) | 926 (100%) | ||
Age | 55.3 ± 12.4 | 59.4 ± 11.9 | 55.5 ± 12.4 | <0.001 | |
Weight | 74.5 ± 15.5 | 71.6 ± 14.0 | 74.3 ± 15.4 | 0.052 | |
Smoker | 758 (95.8%) | 33 (4.2%) | 791 (100%) | 0.122 | |
Non-smoker | 1308 (94.3%) | 79 (5.7%) | 1387 (100%) | ||
Comorbidities | |||||
Dyslipidemia | Yes | 218 (97.3%) | 6 (2.7%) | 224 (100%) | 0.078 |
No | 1848 (94.6%) | 106 (5.4%) | 1954 (100%) | ||
Obesity | Yes | 463 (95.3%) | 23 (4.7%) | 486 (100%) | 0.643 |
No | 1603 (94.7%) | 89 (5.3%) | 1692 (100%) | ||
Diabetes mellitus | Yes | 1266 (93.9%) | 82 (6.1%) | 1348 (100%) | 0.011 |
No | 800 (96.4%) | 30 (3.6%) | 830 (100%) | ||
Hypertension | Yes | 1376 (94.4%) | 82 (5.6%) | 1458 (100%) | 0.147 |
No | 690 (95.8%) | 30 (4.2%) | 720 (100%) | ||
Cerebrovascular accident | Yes | 104 (92.9%) | 8 (7.1%) | 112 (100%) | 0.325 |
No | 1962 (95.0%) | 104 (5.0%) | 2066 (100%) | ||
Peripheral vascular disease | Yes | 36 (92.3%) | 3 (7.7%) | 39 (100%) | 0.467 |
No | 2030 (94.9%) | 109 (5.1%) | 2139 (100%) | ||
Carotid disease | Yes | 29 (87.9%) | 4 (12.1%) | 33 (100%) | 0.067 |
No | 2037 (95.0%) | 108 (5.0%) | 2145 (100%) | ||
Chronic obstructive pulmonary disease | Yes | 86 (95.6%) | 4 (4.4%) | 90 (100%) | 0.759 |
No | 1980 (94.8%) | 108 (5.2%) | 2088 (100%) | ||
New York Heart Association (NYHA) Classification | |||||
0 | 12 (100%) | 0 (0.0%) | 12 (100%) | <0.001 | |
I | 11 (78.6%) | 3 (21.4%) | 14 (100%) | ||
II | 1364 (96.3%) | 52 (3.7%) | 1416 (100%) | ||
III | 576 (93.4%) | 41 (6.6%) | 617 (100%) | ||
IV | 95 (85.6%) | 16 (14.4%) | 111 (100%) | ||
Nature of the operation | |||||
Elective | 1825 (96.4%) | 68 (3.6%) | 1893 (100%) | <0.001 | |
Urgent | 7 (70.0%) | 3 (30.0%) | 10 (100%) | ||
Emergency | 232 (85.0%) | 41 (15.0%) | 273 (100%) | ||
Other parameters | |||||
Creatinine clearance | 81.6 ± 33.4 | 58.0 ± 30.4 | 80.3 ± 33.6 | <0.001 | |
Euroscore II | 2.5 (2.1–4.0) | 6.2 (2.9–12.0) | 2.6 (2.1–4.1) | <0.001 | |
Ejection fraction | 45.2 ± 10.3 | 41.5 ± 12.1 | 45.1 ± 10.4 | <0.001 |
Factors | Beta Coefficient | p-Value | Hazard Ratio (HR) | 95.0% CI for HR | |
---|---|---|---|---|---|
Lower | Upper | ||||
Euroscore II | 0.03 | 0.015 | 1.03 | 1.01 | 1.05 |
Prolonged ventilation | 1.44 | 0.000 | 4.23 | 2.18 | 8.24 |
Reintubation | 1.52 | 0.000 | 4.56 | 2.58 | 8.06 |
Acute kidney injury | 1.22 | 0.000 | 3.39 | 1.85 | 6.20 |
Continuous renal replacement therapy | 0.78 | 0.006 | 2.19 | 1.25 | 3.84 |
Mediastinitis | 1.95 | 0.059 | 7.06 | 0.93 | 53.54 |
Postoperative intra-aortic balloon pump (IABP) | 1.08 | 0.000 | 2.94 | 1.73 | 5.00 |
Postoperative ECMO | 0.90 | 0.012 | 2.46 | 1.22 | 4.94 |
Total Postoperative stay | −0.09 | 0.000 | 0.92 | 0.90 | 0.93 |
Factors | B | p-Value | Odds Ratio | 95% C.I. for Odds Ratio | |
---|---|---|---|---|---|
Lower | Upper | ||||
Nationality (Non-Saudi) | 0.791 | 0.048 | 2.205 | 1.006 | 4.834 |
Propensity Scores | 0.654 | 0.486 | 1.922 | 0.306 | 12.085 |
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Babgi, M.F.; Albar, H.M.; Miny, M.H.; Alzahrani, H.; Ahmad, M.S.; Shaik, R.A.; Ahmed, E.O. Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor. J. Cardiovasc. Dev. Dis. 2023, 10, 292. https://doi.org/10.3390/jcdd10070292
Babgi MF, Albar HM, Miny MH, Alzahrani H, Ahmad MS, Shaik RA, Ahmed EO. Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor. Journal of Cardiovascular Development and Disease. 2023; 10(7):292. https://doi.org/10.3390/jcdd10070292
Chicago/Turabian StyleBabgi, Mohammad F., Haitham M. Albar, Mohammed H. Miny, Haitham Alzahrani, Mohammad Shakil Ahmad, Riyaz Ahmed Shaik, and Elnazeer O. Ahmed. 2023. "Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor" Journal of Cardiovascular Development and Disease 10, no. 7: 292. https://doi.org/10.3390/jcdd10070292
APA StyleBabgi, M. F., Albar, H. M., Miny, M. H., Alzahrani, H., Ahmad, M. S., Shaik, R. A., & Ahmed, E. O. (2023). Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor. Journal of Cardiovascular Development and Disease, 10(7), 292. https://doi.org/10.3390/jcdd10070292