Objectives: Although socioeconomic status (SES) is believed to affect patient outcomes after coronary artery bypass grafting (CABG), readmission data are sparse. In a national cohort, we analyzed the influence of SES on readmission, resource utilization, and mortality after CABG.
Methods: We queried the Nationwide Readmissions Database to identify patients who underwent isolated CABG from January 2016 through December 2018. We derived low, middle, and high SES from ICD-10-CM codes, patient demographics, and neighborhood-level factors. The effect of SES on risk-adjusted outcomes was assessed with multivariable analysis.
Results: Of 523,042 patients who underwent CABG, the 134,039 (25.6%) with low SES were more likely than patients with middle (n=305,572; 58.4%) or high SES (n=83,431; 16%) to be female, younger, from rural areas, and admitted urgently. Patients with low SES were also less likely to be treated at teaching hospitals and had higher Elixhauser comorbidity scores (P<.001 for all). After risk adjustment, patients with low SES had 46% greater odds of in-hospital mortality at the index operation (odds ratio [OR] 1.464 [1.299-1.650]) than patients with high SES. Patients with low SES had the longest index hospital lengths of stay (P<.001). Low SES was associated with greater odds of readmission at 30 days (OR 1.229 [1.170-1.292]), 90 days (OR 1.281 [1.223-1.341]), and within a calendar year (hazard ratio 1.234 [1.193-1.278]) than high SES.
Conclusions: Patients with low SES have greater adjusted odds of mortality and readmission after CABG than patients with high SES.
Keywords: cardiac surgery; coronary artery bypass grafting; disparities; readmission; social determinants of health; socioeconomic status.
Copyright © 2025. Published by Elsevier Inc.