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2003年加利福尼亚冠状动脉搭桥手术结果报告项目中白种人、西班牙裔、亚裔和非裔美国人的临床特征及30天死亡率

Clinical characteristics and 30-day mortality among Caucasians, Hispanics, Asians, And African-Americans in the 2003 California coronary artery bypass graft surgery outcomes reporting program.

作者信息

Yeo Khung Keong, Li Zhongmin, Amsterdam Ezra

机构信息

Division of Cardiovascular Medicine, University of California, Davis Medical Center, Sacramento, California, USA.

出版信息

Am J Cardiol. 2007 Jul 1;100(1):59-63. doi: 10.1016/j.amjcard.2007.02.053. Epub 2007 May 11.

Abstract

The importance of differences in clinical characteristics between ethnic groups on operative mortality of coronary artery bypass grafting (CABG) has not been clarified. Data reporting to the California CABG outcomes reporting program is mandated under state law in California. Data from 121 hospitals in 2003 were analyzed, including clinical characteristics and predicted and observed operative mortalities in patients who underwent isolated CABG. In total 21,272 isolated CABGs were reported in 2003. Compared with Caucasians (n = 15,069), Hispanics (n = 2,561), Asians (n = 1,772), and African-Americans (n = 785) were younger, more likely to be women, and had more hypertension, diabetes, renal failure, and severe liver disease (all p values <0.05). Hispanics had more heart failure and Asians had a lower body mass index compared with Caucasians, whereas African-Americans had a higher body mass index and more peripheral artery disease and heart failure (all p values <0.05). Based on a multivariate model, the predicted operative mortality for Hispanics (3.2%), Asians (3.3%), and African-Americans (3.6%) was higher (all p values <0.001) than that of Caucasians (2.8%). However, observed operative mortality was similar across ethnic groups, although there was a trend toward higher mortality in Asians compared with Caucasians (3.5% vs 2.8%, p = 0.077). In conclusion, significant differences in risk profile for CABG exist across ethnicities. Although the predicted operative mortality for Hispanics, Asians, and African-Americans was significantly higher than that for Caucasians, there was no significant difference in the observed operative mortality.

摘要

不同种族间临床特征差异对冠状动脉旁路移植术(CABG)手术死亡率的影响尚未明确。根据加利福尼亚州法律,需向加利福尼亚CABG结果报告项目上报数据。分析了2003年来自121家医院的数据,包括接受单纯CABG患者的临床特征、预测及观察到的手术死亡率。2003年共报告了21272例单纯CABG手术。与白种人(n = 15069)相比,西班牙裔(n = 2561)、亚裔(n = 1772)和非裔美国人(n = 785)年龄更小,女性比例更高,且高血压、糖尿病、肾衰竭和严重肝病更多(所有p值<0.05)。与白种人相比,西班牙裔心力衰竭更多,亚裔体重指数更低,而非裔美国人体重指数更高,外周动脉疾病和心力衰竭更多(所有p值<0.05)。基于多变量模型,西班牙裔(3.2%)、亚裔(3.3%)和非裔美国人(3.6%)的预测手术死亡率高于白种人(2.8%)(所有p值<0.001)。然而,各民族间观察到的手术死亡率相似,尽管亚裔与白种人相比有死亡率更高的趋势(3.5%对2.8%,p = 0.077)。总之,不同种族间CABG风险特征存在显著差异。尽管西班牙裔、亚裔和非裔美国人的预测手术死亡率显著高于白种人,但观察到的手术死亡率并无显著差异。

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