County-level food insecurity is associated with outcomes following cardiac surgery.
Am J Surg
; 237: 115907, 2024 Nov.
Article
in En
| MEDLINE
| ID: mdl-39197233
ABSTRACT
BACKGROUND:
As there is limited literature evaluating food insecurity status (FI) and surgical outcomes, we sought to assess the association between county-level FI and outcomes following cardiac surgery.METHODS:
In a retrospective cohort, patients who underwent coronary artery bypass grafting between 2016 and 2020 were identified utilizing the Medicare Standard Analytic Files. Using County-level FI, patients were stratified into low, moderate, and high cohorts. The primary outcome was textbook outcomes, a measure of "optimal" post-operative outcomes. Adjusted multiple logistic regression and Cox regression models were utilized to evaluate outcomes and survival.RESULTS:
Among 267,914 patients, patients residing in high FI regions were less likely to achieve textbook outcomes (OR 0.94, 95 â% CI 0.90-0.99). When evaluating individual post-operative outcomes of interest, patients residing in high FI regions also had a greater odd of 90-day mortality (OR 1.24, 95 â% CI 1.12-1.36) and extended LOS (OR 1.07, 95 â% CI 1.01-1.14) (all p â< â0.0001). Moreover, this population was also at greater risk of 5-year mortality (HR 1.11, 95 â% CI 1.06-1.17) compared with their counterparts from low food insecurity regions. Racial disparities persisted in high FI counties as Black patients had a greater risk of 5-year mortality (HR 1.27, 95 â% CI 1.17-1.38, p â< â0.0001) compared with White patients within the same FI level.CONCLUSIONS:
County-level FI was associated with worse outcomes following cardiac surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Bypass
/
Food Insecurity
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Surg
Year:
2024
Document type:
Article
Affiliation country:
United States
Country of publication:
United States