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    Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: Insights from a multicentre registry

    Access Status
    Fulltext not available
    Authors
    Shi, W.
    Yap, C.
    Newcomb, A.
    Hayward, P.
    Tran, L.
    Reid, Christopher
    Smith, J.
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Shi, W. and Yap, C. and Newcomb, A. and Hayward, P. and Tran, L. and Reid, C. and Smith, J. 2014. Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: Insights from a multicentre registry. Heart Lung and Circulation. 23 (8): pp. 726-736.
    Source Title
    Heart Lung and Circulation
    DOI
    10.1016/j.hlc.2014.02.008
    ISSN
    1443-9506
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/44438
    Collection
    • Curtin Research Publications
    Abstract

    Background: We examined whether socioeconomic status and rurality influenced outcomes after coronary surgery. Methods: We identified 14,150 patients undergoing isolated coronary surgery. Socioeconomic and rurality data was obtained from the Australian Bureau of Statistics and linked to patients' postcodes. Outcomes were compared between categories of socioeconomic disadvantage (highest versus lowest quintiles, n= 3150 vs. 2469) and rurality (major cities vs. remote, n=9598 vs. 839). Results: Patients from socioeconomically-disadvantaged areas experienced a greater burden of cardiovascular risk factors including diabetes, obesity and current smoking. Thirty-day mortality (disadvantaged 1.6% vs. advantaged 1.6%, p>0.99) was similar between groups as was late survival (7 years: 83±0.9% vs. 84±1.0%, p=0.79). Those from major cities were less likely to undergo urgent surgery. There was similar 30-day mortality (major cities: 1.6% vs. remote: 1.5%, p=0.89). Patients from major cities experienced improved survival at seven years (84±0.5% vs. 79±2.0%, p=0.010). Propensity-analysis did not show socioeconomic status or rurality to be associated with late outcomes. Conclusion: Patients presenting for coronary artery surgery from different socioeconomic and geographic backgrounds exhibit differences in their clinical profile. Patients from more rural and remote areas appear to experience poorer long-term survival, though this may be partially driven by the population's clinical profile. © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).

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