Mandal A K, Kaushik V S, Oparah S S
Department of Surgery and Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA.
J Natl Med Assoc. 1991 Jun;83(6):519-21.
Incidence of coronary heart disease deaths has been reported to be higher in low socioeconomic groups compared to affluent subjects. In addition, a higher mortality rate has been reported at centers doing fewer open heart surgeries. This article presents evidence in variance with these convictions. We report a single team's experience with coronary artery surgery on 76 low socioeconomic, predominantly black patients (84%) over a period of 8 years. The volume of open heart surgery per year was less than 20. The overall mortality rate of 5.3%, infection rate of 1.3%, and perioperative infarction rate of 7.9% are not significantly different from the reported experience of high-volume surgical centers on similar patients during the same period. Thus, it is possible to obtain comparable results of myocardial revascularization surgery in low-volume, socioeconomically disadvantaged, inner city minority populations.
据报道，与富裕人群相比，社会经济地位较低群体的冠心病死亡发生率更高。此外，据报道，开展心脏直视手术较少的中心死亡率更高。本文提出了与这些观点相悖的证据。我们报告了一个团队在8年时间里对76名社会经济地位较低、以黑人为主（84%）的患者进行冠状动脉手术的经验。每年的心脏直视手术量少于20例。总体死亡率为5.3%，感染率为1.3%，围手术期梗死率为7.9%，与同期高手术量中心对类似患者的报告经验相比，差异无统计学意义。因此，在手术量较少、社会经济条件不利的市中心少数族裔人群中，有可能获得类似的心肌血运重建手术结果。
