Evidence map›Paper›PMID 37385524›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2024

Socioeconomic disparities in midterm outcomes after repair for degenerative mitral regurgitation.

Jad Malas, Qiudong Chen, Dominic Emerson, George Gill, Georgina Rowe, Natalia Egorova, Alfredo Trento, Joanna Chikwe, Michael E Bowdish

Open access · greenAbstract read
In one paragraph

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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jad MalasDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Qiudong ChenDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Dominic EmersonDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
George GillDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Georgina RoweDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Natalia EgorovaDepartment of Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Alfredo TrentoDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Joanna ChikweDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif.
Michael E BowdishDepartment of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, Calif. Electronic address: Michael.Bowdish@cshs.org.
Cedars-Sinai Medical Center · USIcahn School of Medicine at Mount Sinai · US

Funding

Training in Advanced Heart Disease ResearchT32HL116273 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI Joshua I Goldhaber, EDUARDO MARBAN · 2013 to 2026
$5.6M
NHLBI NIH HHS T32 HL116273
6 · The paper itself

Abstract

objectiveThe influence of socioeconomic disparities on survival after mitral repair is poorly defined. We examined the association between socioeconomic disadvantage and midterm outcomes of repair in Medicare beneficiaries with degenerative mitral regurgitation.

methodsUS Centers for Medicare and Medicaid Services data were used to identify 10,322 patients undergoing isolated first-time repair for degenerative mitral regurgitation between 2012 and 2019. Zip code-level socioeconomic disadvantage was dichotomized with the Distressed Communities Index, which incorporates education level, poverty, unemployment, housing security, median income, and business growth; those with Distressed Communities Index score ≥80 were classified as distressed. The primary outcome was survival, censored at 3 years. Secondary outcomes included cumulative incidences of heart failure readmission, mitral reintervention, and stroke.

resultsOf the 10,322 patients undergoing degenerative mitral repair, 9.7% (n = 1003) came from distressed communities. Patients from distressed communities underwent surgery at lower volume centers (11 vs 16 cases/year) and traveled further for surgical care (40 vs 17 miles) (both P values < .001). At 3 years, unadjusted survival (85.4%; 95% CI, 82.9%-87.5% vs 89.7%; 95% CI, 89.0%-90.4%) and cumulative incidence of heart failure readmission (11.5%; 95% CI, 9.6%-13.7% vs 7.4%; 95% CI, 6.9%-8.0%) were worse in patients from distressed communities (all P values < .001), whereas mitral reintervention rates were similar (2.7%; 95% CI, 1.8%-4.0% vs 2.8%; 95% CI, 2.5%-3.2%; P = .75). After adjustment, community distress was independently associated with 3-year mortality (hazard ratio, 1.21; 95% CI, 1.01-1.46) and heart failure readmissions (hazard ratio, 1.28; 95% CI, 1.04-1.58).

conclusionsCommunity-level socioeconomic distress is associated with worse outcomes in degenerative mitral repair among Medicare beneficiaries.

Indexed as

MedicareMitral Valve InsufficiencyAgedAged, 80 and overFemaleHealthcare DisparitiesHeart FailureHumansMaleMitral ValvePatient ReadmissionPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsSocial Determinants of Healthdegenerative mitral regurgitationdisparitieshealth inequitiesmidterm outcomesprimary mitral regurgitationsocioeconomic

Identifiers

PMID37385524
PMCPMC11181753
OpenAlexW4382199685

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.