• Posted October 22, 2024

Black Patients 22% More Likely to Die After Bypass Surgeries

Heart bypass operations have gotten safer, but not everyone is benefiting equally: New data shows that Black patients face a 22% higher odds of dying in the hospital after their surgeries.

“We found Black patients who have coronary artery bypass surgery experience higher rates of severe postoperative complications, including death and cardiac arrest," said study lead author Dr. Vinicius Moreira.

"These alarming statistics call for urgent action from governments and health care systems," added Moreira, who is chief anesthesiology resident at Advocate Illinois Masonic Medical Center in Chicago.

His team presented its findings Monday at the the annual meeting of the American Society of Anesthesiologists in Philadelphia.

Bypass is technically known as coronary artery bypass grafting (CABG). When a vital coronary artery becomes clogged with cholesterol-laden plaques, surgeons take a segment of artery from an area such as the patient's leg, arm or chest and graft it into the same spot, restoring proper blood flow.

"Advances in cardiovascular medicine, such as minimally invasive cardiac procedures and modern mechanical circulatory support devices, have increased life expectancy" after a bypass procedure, Moreira noted in a meeting news release.

However, are all patients reaping this benefit?

To find out, his team used a national database to track outcomes for just over 1.2 million U.S. patients who underwent bypass between 2016 and 2021. About 76% of the patients were white, just over 7.4% were Hispanic and 6.75% were Black.

Patients averaged 77 years of age at the time of their surgeries, although minority patients tended to be younger: 63 years old for Black patients and 64 years old for Hispanic patients.

Despite being younger, Black patients tended to be more likely to die in the hospital following a bypass surgery than whites.

In total, 3.2% of Black patients passed away soon after their operation, compared to 2.4% of white patients and 2.5% of Hispanics, the research showed.

That's a 22% higher odds for post-op death for Black patients, Moreira's team calculated, and Black patients also had a 23% higher odds for cardiac arrest after their procedure, compared to whites.

Hospital stays following a bypass operation were also longer for Black patients: An average of 11.8 days compared to 9.6 days for white patients and 10.7 days for Hispanic patients.

All of this also meant higher hospital bills for minority patients. The average bill for a bypass for a Black patient was $23,000 higher than the bill presented to white patients.

Hispanic patients incurred even higher bills: $78,000 more, on average, than the bill presented to white patients, the study found.

Beyond their higher death rate after a bypass surgery, too many Black Americans who require bypass might not be getting the life-extending operation, Moreira added.

"We found that compared to white patients, a lower proportion of Black patients had bypass surgery when it was indicated,” Moreira said.

"It is imperative that modern policies focus on improving the screening, diagnosis and treatment of chronic conditions that disproportionately impact the Black population and other minorities," he added.

According to Moreira, steps could be taken to gain equity for Black heart surgery patients.

Surgeons and anesthesiologists could work to develop better preventive measures to lower the risk of complications for patients deemed to be at higher risk, he said.

And since obesity ups the odds for complications after bypass, anything governments can do to lower obesity rates among minorities would help ease disparities, as well.

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

Find out more about bypass surgeries at the American Heart Association.

SOURCE: American Society of Anesthesiologists, news release, Oct. 21, 2024