Black patients do not have the same level of access to new, safer procedures for heart surgery as do White patients, giving them dramatically higher odds of complications or death, a new study says. Photo by torwaiphoto/shutterstock
Dec. 21 (UPI) — Black patients do not have the same level of access to new, safer procedures for heart surgery as do White patients, giving them dramatically higher odds of complications or death, a new study says.
That’s according the University of Rochester Medical Center in Rochester, N.Y., where researchers underscored as “troubling” findings that were published Wednesday in JAMA Network Open.
The researchers found that non-Hispanic Black patients had 35% lower odds of undergoing minimally invasive mitral valve surgery, and 62% higher odds of having serious complications or dying, compared with non-Hispanic White patients.
Hispanic patients had 26% higher odds of major complications or death compared to White patients, but they were not less likely to get minimally invasive surgery, the researchers found.
“We’ve known for 35 years that historically marginalized racial and ethnic groups tend to have less access to cardiovascular procedures,” Dr. Laurent G. Glance, the study’s lead author and a professor of anesthesiology and perioperative medicine at the University of Rochester Medical Center, said in a news release.
He added: “This study highlights the fact that even in 2022 if you’re not White, you don’t get the same therapies that white people do.”
Traditional heart surgery, which involves fully opening the chest and cutting through the breastbone, comes with a high risk of complications and a long recovery time, the release said.
By contrast, newer, minimally invasive heart procedures avoid a lot of that risk and speed a person’s recovery time.
The researchers analyzed data from 104,000 patients across 1,085 hospitals who underwent mitral valve surgery between 2014 and 2019, gathered from the Society of Thoracic Surgeons National Adult Cardiac Surgery Database.
According to the researchers, several patterns in the data may show the factors contributing to this inequity:
Black patients were more likely to have insurance from the Medicaid program, seek treatment at under-resourced hospitals, and receive treatment from less experienced surgeons — who were 20 times less likely to perform minimally invasive procedures than surgeons who perform a high volume of mitral valve surgeries.
“Minimally invasive surgeries set patients up for the best outcomes,” Dr. Peter Knight, the study’s co-author, chief of cardiac surgery and distinguished professor who has spearheaded the adoption of minimally invasive procedures at the University of Rochester Medical Center. “That is why the inequities we found in this study are so troubling.”
The researchers said the study’s findings suggest that efforts to reduce inequity in cardiovascular medicine may need to include increasing access to private commercial insurance and lowering the age of eligibility or creating a buy-in model for Medicare.
In theory, increasing the number of people who have insurance via Medicaid expansion “should increase access to these procedures, but in this study, we found that just getting people insurance wasn’t enough. The type of insurance also mattered,” Glance said.
The researchers said referrals to regional care centers could improve Black patients’ access to highly experienced surgeons, especially for people living in rural areas.
