Purpose: Racial disparities in post-operative mortality following coronary artery bypass grafting (CABG) have been investigated, although underlying causes have yet to be elucidated. This study aims to analyze historical trends in 30-day postoperative mortality rates between black and white patients, as well as the accuracy and methods used to elicit them.

Methods: Studies published between 1984 and 2023 were collected from a nonstructured review in PubMed. Article inclusion criteria were patients of all ages who underwent CABG and explicit reporting of 30-day post-operative mortality in black and white patients. Studies that focused on non-CABG cardiac surgeries and studies that did not report 30-day mortality rates stratified by race were excluded. Studies meeting inclusion criteria were evaluated using title and abstract review. Subsequent full-text screening and data extraction were performed.

Results: Differences in 30-day post-operative mortality rates still exist following CABG between black and white patients. (Image 1) Several studies have analyzed 30-day mortality rates stratified by race following CABG, however, there is a paucity of large database studies.(Table 1) Angraal et al. recently utilized Medicare data from the Centers for Medicare & Medicaid Services (CMS) to report on CABG outcomes in patients over age 65 among different races between 1999-2014.(1) Between 2011 and 2020, the mean age of a patient undergoing primary isolated CABG was 66.0 years.(2) In our experience, 61.3% of patients who underwent CABG in the past five years at our academic inner-city hospital were below 65 years of age and exhibited a greater number of comorbid conditions compared with their older counterparts, and there may not be a database that accurately captures the scope of outcomes and disparities that exist in and between patients of different racial backgrounds.

Conclusion: There is no standardized way to evaluate CABG outcomes between patients of different racial backgrounds, leading to potential discrepancies between true and reported 30-day mortality rates. However, previous studies show differences. Thus, a standardized system is necessary to accurately assess mortality between races and to define areas for quality improvement.