Trends in the Utilization and Mortality for Coronary Artery Bypass Graft (CABG) Surgery in California Hospitals
CABG utilization in California decreased from 2009 to 2022. There were 62.2 CABG surgeries per 100,000 adult population in 2009 compared to 49.8 CABG surgeries per 100,000 adult population in 2022.
Why Report Trends in Utilization and Mortality for CABG Surgery?
CABG surgery, a major interventional procedure to treat coronary artery diseases, is the most common type of open-heart surgery and the costliest procedure in California. Other studies have shown large disparities in the use of CABG procedures and outcomes by sex and race/ethnicity.*
This report evaluates the changes in CABG utilization and outcomes in California by age, assigned sex at birth and race/ethnicity over time which is important in the evaluation of hospital resources, regional health policy, quality improvement, and the promotion of health equity.
Key Findings
- Males had higher CABG utilization rates than females, but the rate of decline over time was much greater for females (34.0 percent) than males (15.4 percent).
- CABG utilization rates decreased in all age subgroups over time. Adults 65 to 84 years of age had the highest CABG utilization, however those 85 years of age and older had the highest rate of decline (70.8 percent) compared to those 65 to 84 years of age (39.0 percent), 18 to 44 years of age (16.7 percent) and 45 to 64 years of age (16.4 percent)
- CABG utilization rates decreased in all race/ethnicity subgroups. Whites had the highest CABG utilization rate and the highest rate of decline (26.9 percent) compared to Blacks (17.6 percent), and Hispanics (1.3 percent).
- CABG utilization rate increased for American Indian / Alaskan Native adults (25.3 percent) and Asian / Pacific Islander adults (15.5 percent) subgroups over the 13-year period.
- The statewide rate for in-hospital mortality was stable over time with the highest mortality rate in 2020 (2.3 percent). This trend was consistent among all subgroups.
- During 2009-2022, the mortality rate remained higher in females (ranging from 3.5 percent to 5.0 percent) compared to males (1.8 percent to 2.3 percent).
- Adults 85 years of age and older had the highest in-hospital mortality rate (8.8 percent in Year 2022), followed by those 65 to 84 years of age (3.1 percent), 18 to 44 years of age (2.0 percent) and 45 to 64 years of age (1.6 percent).
- In-hospital mortality rates for Blacks (3.2 percent in Year 2022) are often higher than rates for other race/ethnic subgroups, but do vary by year; this variation is likely due to low volume of procedures when compared to other racial/ethnic groups.
How HCAI Created this Product
This product was created based on CABG surgery clinical data collected by the California Cardiovascular Outcomes Reporting Program (CCORP) from 2009 to 2022. Clinical CABG data were linked to Patient Discharge Data and California State death records.
Utilization rates by assigned sex at birth, age, and race/ethnicity were calculated using Single-Race Population Estimates by State from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER). The data were updated annually by the National Center for Health Statistics.
*References:
- Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. J Am Heart Assoc. 2018:118.009014.
- Dani SS, Minhas AMK, Arshad A, Krupica T, Goel SS, Virani SS, Sharma G, Blankstein R, Blaha MJ, Al-Kindi SJ, Nasir K, Khan SU. Trends in Characteristics and Outcomes of Hospitalized Young Patients Undergoing Coronary Artery Bypass Grafting in the United States, 2004 to 2018. J Am Heart Assoc. 2021;121:021361.
- Yaffee DW, McKay RG, Mather J, Sorensen SV, Kehm A, McMahon S, Sutton T, Hashim SW. Racial Disparities in Atrial Fibrillation After Coronary Artery Bypass: Impact of Left Atrial Volume. Ann Thorac Surg Short Reports. 2023;1:631-634.
Additional Information
Topic: Healthcare Quality
Source Link: Healthcare Utilization Data, Coronary Artery Bypass Graft Reports
Citation: HCAI – Healthcare Utilization; Patient-Level Administrative Data; Trends in the Utilization and Outcome of Coronary Artery Bypass Grafting in California Hospitals
Temporal Coverage: 2009-2022
Spatial/Geographic Coverage: Statewide
Frequency: Annually