ArticleThe Journal of thoracic and cardiovascular surgery2024
Socioeconomic distress is associated with failure to rescue in cardiac surgery.
Article in The Journal of thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Pediatric Tracheostomy Speaking Valve Assessment: A Golden Opportunity for Quality Improvement and Reduction of Healthcare Disparities.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- The association between the Distressed Communities Index and failure to rescue after cardiac surgery among Medicare beneficiaries.The Journal of thoracic and cardiovascular surgery · 2026Article
- Regional travel distance is not associated with operative mortality in acute type A aortic dissection.JTCVS open · 2026Article
- The impact of race and sex on recent mortality trends after coronary artery bypass grafting.JTCVS open · 2026Article
- The influence of socioeconomic status on the decision to use bilateral internal mammary artery grafting in coronary artery bypass surgery.JTCVS open · 2025Article
- Disparities in 180-day infection rates following coronary artery bypass grafting and aortic valve replacement.The Journal of thoracic and cardiovascular surgery · 2025Article
- Socioeconomic deprivation is associated with worse in-hospital survival after isolated coronary artery bypass grafting in the UK.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repair.JTCVS open · 2025Article
- Patients from distressed communities have decreased survival after open thoracic aneurysm repair.JTCVS open · 2025Article
- Persistent income-based disparities in clinical outcomes of cardiac surgery across the United States: A contemporary appraisal.JTCVS open · 2024Article
- Extracorporeal Life Support Organization Center of Excellence recognition is associated with improved failure to rescue after cardiac arrest.The Journal of thoracic and cardiovascular surgery · 2024Article
- Heart transplantation in patients from socioeconomically distressed communities.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- The Society of Thoracic Surgeons Definition of Failure to Rescue Should Consider Including Cardiac Arrest.The Annals of thoracic surgery · 2023Article
- Delirium is associated with failure to rescue after cardiac surgery.JTCVS open · 2023Article
- Comparison of failure to rescue in younger versus elderly patients following lung cancer resection.JTCVS open · 2023Article
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Authors and funding
11 authors.
Funding
Abstract
objectiveThe influence of socioeconomic determinants of health on failure to rescue (mortality after a postoperative complication) after cardiac surgery is unknown. We hypothesized that increasing Distressed Communities Index, a comprehensive socioeconomic ranking by ZIP code, would be associated with higher failure to rescue.
methodsPatients undergoing Society of Thoracic Surgeons index operation in a regional collaborative (2011-2021) who developed a failure to rescue complication were included. After excluding patients with missing ZIP code or Society of Thoracic Surgeons predicted risk of mortality, patients were stratified by Distressed Communities Index scores (0-no distress, 100-severe distress) based on education level, poverty, unemployment, housing vacancies, median income, and business growth. The upper 2 quintiles of distress (Distressed Communities Index >60) were compared to all other patients. Hierarchical logistic regression analyzed the association between Distressed Communities Index and failure to rescue.
resultsA total of 4004 patients developed 1 or more of the defined complications across 17 centers. Of these, 582 (14.5%) experienced failure to rescue. High socioeconomic distress (Distressed Communities Index >60) was identified among 1272 patients (31.8%). Before adjustment, failure to rescue occurred more frequently among those from socioeconomically distressed communities (Distressed Communities Index >60; 16.9% vs 13.4%, P = .004). After adjustment, residing in a socioeconomically distressed community was associated with 24% increased odds of failure to rescue (odds ratio, 1.24; confidence interval, 1.003-1.54; P = .044).
conclusionsIncreasing Distressed Communities Index, a measure of poor socioeconomic status, is associated with greater risk-adjusted likelihood of failure to rescue after cardiac surgery. These findings highlight that current quality metrics do not account for socioeconomic status, and as such underrepresent procedural risk for these vulnerable patients.
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