AIMS: Disparities for Maori exist in New Zealand for cardiovascular risk factors, events and access to revascularisation. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) between Maori and Europeans in New Zealand. METHODS: Patients undergoing isolated CABG at Auckland City Hospital from July 2010-June 2012 were retrospectively analysed. RESULTS: Of 818 patients, 82 were Maori and 444 were Europeans. Maori were younger (60.0 vs 67.9 years, p<0.001), had higher NZ deprivation index (8.5 vs 5.0, p<0.001), body mass index (32.6 vs 28.8 kg/m2, p<0.001), higher prevalence of heart failure (11.0% vs 2.3%, p<0.001), diabetes (43.9% vs 24.1%, p<0.001), smoking (39.0% vs 13.1%, p<0.001), dialysis (4.9% vs 0.9%, p=0.023), lower ejection fraction (p=0.001), lower additive EuroSCORE 1 (4.1 vs 4.8, p=0.041) and longer cardiopulmonary bypass time (100 vs 89 minutes p<0.001). Maori ethnicity was independently associated with 30-day mortality, odds ratio (OR) 6.35, 95% confidence interval 1.01-39.9, p=0.046; and surgical morbidity OR 2.05, 1.04-4.04, p=0.040. Maori had a trend for higher mortality at 1.4 plus or minus 0.6 years (hazards ratio 2.91, 0.92-9.20, p=0.069), 1-year mortality 6.3% vs 1.5%. CONCLUSION: Despite being younger, Maori undergoing CABG had more comorbidities and socioeconomic deprivation. Maori had higher mortality and complication rates. Maori should have earlier access to CABG.
AIMS: Disparities for Maori exist in New Zealand for cardiovascular risk factors, events and access to revascularisation. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) between Maori and Europeans in New Zealand. METHODS:Patients undergoing isolated CABG at Auckland City Hospital from July 2010-June 2012 were retrospectively analysed. RESULTS: Of 818 patients, 82 were Maori and 444 were Europeans. Maori were younger (60.0 vs 67.9 years, p<0.001), had higher NZ deprivation index (8.5 vs 5.0, p<0.001), body mass index (32.6 vs 28.8 kg/m2, p<0.001), higher prevalence of heart failure (11.0% vs 2.3%, p<0.001), diabetes (43.9% vs 24.1%, p<0.001), smoking (39.0% vs 13.1%, p<0.001), dialysis (4.9% vs 0.9%, p=0.023), lower ejection fraction (p=0.001), lower additive EuroSCORE 1 (4.1 vs 4.8, p=0.041) and longer cardiopulmonary bypass time (100 vs 89 minutes p<0.001). Maori ethnicity was independently associated with 30-day mortality, odds ratio (OR) 6.35, 95% confidence interval 1.01-39.9, p=0.046; and surgical morbidity OR 2.05, 1.04-4.04, p=0.040. Maori had a trend for higher mortality at 1.4 plus or minus 0.6 years (hazards ratio 2.91, 0.92-9.20, p=0.069), 1-year mortality 6.3% vs 1.5%. CONCLUSION: Despite being younger, Maori undergoing CABG had more comorbidities and socioeconomic deprivation. Maori had higher mortality and complication rates. Maori should have earlier access to CABG.
Authors: Jason K Gurney; Melissa McLeod; James Stanley; Doug Campbell; Luke Boyle; Elizabeth Dennett; Sarah Jackson; Jonathan Koea; Dick Ongley; Diana Sarfati Journal: BMJ Open Date: 2020-09-24 Impact factor: 2.692