Poor More Likely to Die Following Heart Surgery

WEDNESDAY April 7, 2010 -- Poor people are more likely to die within five to 10 years after heart surgery than more affluent people, U.S. researchers report.

They followed 15,156 white men, 6,932 white women, 678 black men and 564 black women who had heart bypass or valve surgery between 1995 and 2005 and found that the poorest patients were 19 to 26 percent more likely to die within five years of surgery than the wealthiest patients, regardless of race or gender.

"We were surprised that consistently and pervasively, through every way of looking at the data, it turns out this isn't about skin color or gender. It's about being poor," study author Colleen G. Koch, a cardiac anesthesiologist and vice chair for research and education in the department of cardiothoracic anesthesia at the Cleveland Clinic, said in a news release.

However, the researchers did find that poor patients were significantly more likely to be black and female.

Koch and colleagues also found that poorer patients had more atherosclerosis, serious cardiovascular disease, prior heart attacks, left ventricular dysfunction, heart failure, high blood pressure, prior stroke, peripheral artery disease, treated diabetes, and chronic obstructive pulmonary disease. They were also more likely to be smokers.

The study appears in the current issue of the journal Circulation: Cardiovascular Quality and Outcomes.

Poorer patients didn't have a significantly higher death rate while in hospital immediately after surgery. Factors such as financial problems, educational barriers, and lack of referrals to cardiac rehabilitation programs may contribute to increased risk of death among poor patients in the years after heart surgery, Koch said.

Their survival rates might increase through improved access to primary prevention, earlier identification of risk factors, better access to long-term interventions, and enrollment in cardiac rehab programs, Koch said. Cardiac rehab typically includes monitored exercise, nutritional counseling, emotional support, and education.

More information

The Society of Thoracic Surgeons explains what to expect after heart surgery.

Posted: April 2010


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