Racial disparity in cardiac surgery risk and outcome: Report from a statewide quality initiative

Abstract Background Racial disparities persist in healthcare. Our study objective was to evaluate racial disparity in cardiac surgery in Maryland. Methods Patients were identified using a statewide database. Demographics, comorbidities, and predicted risk of mortality were compared between races. Crude mortality and incidence of complications were compared between groups, as were risk-adjusted odds for mortality and major morbidity or mortality. Results The study included 23,094 patients. The majority of patients were white (75.8%), followed by African American (16.3%), Asian (3.8%), and other races (4.1%). African Americans had higher preoperative risk for mortality based on the Society of Thoracic Surgeons predictive models compared to white patients (3.0% versus 2.3%, P Conclusions African American cardiac surgery patients have the highest preoperative risk in Maryland. Patients appeared to receive excellent cardiac surgery care, regardless of race, as risk adjusted mortality did not differ between groups and African American patients had lower risk adjusted odds of major morbidity or mortality than white patients. Future interventions in Maryland should be aimed at reducing preoperative risk disparity in cardiac surgery patients.