Effect of Neighborhood Socioeconomic Factors on Readmissions and Mortality After Coronary Artery Bypass Grafting

BackgroundSocial determinants of health, including neighborhood socioeconomic status (NSES), are increasingly being associated with disparate outcomes in those undergoing cardiac procedures. The objective this study was to determine the effect NSES on after coronary artery bypass grafting (CABG).MethodsAdults isolated CABG between July 2011 and December 2017 were retrospectively reviewed. Neighborhood median household income (NMI) high school graduation rate (NHS) obtained by individual patient ZIP code from American FactFinder Database. Primary outcome 5-year all-cause mortality stratified NMI quartile. Secondary end points included risk NHS, freedom frequency readmission, readmission predictors.ResultsDuring period, 5243 patients underwent CABG. Increasing quartile increasing age, male sex, white race, decreased diabetes prevalence, active smoker status, lung disease (all P < .05). Although no difference 30-day observed, lower quartiles increased longitudinal through 5 years (log-rank .01). Lower blood transfusions sternal wound infections. Multivariable modeling demonstrated multiple complex associations variables (race, NMI, NHS) for readmission.ConclusionsNSES affects longer-term Patient-focused interventions incorporation into prediction models may improve Social (CABG). Adults predictors. During readmission.