Coronary artery bypass grafting in Native Americans - A higher risk of death compared to other ethnic groups?

BACKGROUND. While the efficacy and safety of coronary artery bypass graftin g (CABG) has been established in several clinical trials, little is known a bout its outcomes in Native Americans. MEASUREMENTS AND MAIN RESULTS: We assessed clinical outcomes associated wit h CABG in 155 Native Americans using a, national database of 18,061 patient s from 25 nongovernmental, not-for-profit U.S. health care facilities. Pati ents were classified into five groups: 1) Native American, 2) white, 3) Afr ican American, 4) Hispanic, and 5) Asian. We evaluated for ethnic differenc es in in-hospital mortality and length of stay, and after adjusting for age , gender, surgical priority, case-mix severity, insurance status, and facil ity characteristics (volume, location, and teaching status). Overall, we fo und the adjusted risk for in-hospital death to be higher in Native American s when compared to whites (odds ratio [OR], 3.8; 95% confidence interval [C I], 1.5 to 9.8), African Americans (OR, 3.4; 95% CI, 1.1 to 9.9), Hispanics (OR, 7.1; 95% CI, 2.5 to 20.3), and Asians (OR, 2.8, 95% CI, 1.1 to 7.0). No significant differences were found in length of stay after adjustment ac ross ethnic groups. CONCLUSIONS. The risk of in-hospital death following CABG maybe higher in N ative Americans than in other ethnic groups. Given the small number of Nati ve Americans in the database (n = 155), however, further research will be n eeded to confirm these findings.