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Objectives: Although socioeconomic status (SES) is believed to affect patient outcomes after coronary artery bypass grafting (CABG), readmission data are sparse. In a national cohort, we analyzed the influence of SES on readmission, resource utilization, and mortality after CABG., Methods: We queried the Nationwide Readmissions Database to identify patients who underwent isolated CABG from January 2016 through December 2018. We derived low, middle, and high SES from International Classification of Diseases, 10th Revision, Clinical Modification codes, patient demographics, and neighborhood-level factors. The effect of SES on risk-adjusted outcomes was assessed with multivariable analysis., Results: Of 523,042 patients who underwent CABG, the 134,039 (25.6%) with low SES were more likely than patients with middle (n = 305,572 [58.4%]) or high SES (n = 83,431 [16%]) to be female, younger, from rural areas, and admitted urgently. Patients with low SES were also less likely to be treated at teaching hospitals and had higher Elixhauser comorbidity scores (P < .001 for all). After risk adjustment, patients with low SES had 46% greater odds of in-hospital mortality at the index operation (odds ratio, 1.464; 95% CI, 1.299-1.650) than patients with high SES. Patients with low SES had the longest index hospital length of stay (P < .001). Low SES was associated with greater odds of readmission at 30 days (odds ratio, 1.229; 95% CI, 1.170-1.292), 90 days (odds ratio, 1.281; 95% CI, 1.223-1.341), and within a calendar year (hazard ratio, 1.234; 95% CI, 1.193-1.278) than high SES., Conclusions: Patients with low SES have greater adjusted odds of mortality and readmission after CABG than patients with high SES., Competing Interests: Conflict of Interest Statement Dr Coselli participates in clinical studies with and/or consults for Terumo Aortic, Medtronic, W. L. Gore & Associates, CytoSorbents, Edwards Lifesciences, and Abbott Laboratories and receives royalties and grant support from Terumo Aortic. Dr Coselli's relationships are with the US centers of both CytoSorbents and Terumo. Dr Moon serves on Medtronic's advisory board. Dr Chatterjee has served on advisory boards for Edwards Lifesciences, La Jolla Pharmaceutical Company, Eagle Pharmaceuticals, and Baxter Pharmaceuticals. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2025. Published by Elsevier Inc.)

Objective: We evaluated community socioeconomic factors in patients who had unplanned readmission after undergoing proximal aortic surgery (ascending aorta, aortic root, or arch)., Methods: Unplanned readmissions for any reason within 60 days of the index procedure were reviewed by race, acuity at presentation, and gender. We also evaluated 3 community socioeconomic factors: poverty, household income, and education. Kaplan-Meier survival curves were used to assess long-term survival differences by group (race, acuity, and gender)., Results: Among 2339 patients who underwent proximal aortic surgery during the 20-year study period and were discharged alive, our team identified 146 (6.2%) unplanned readmissions. Compared with White patients, Black patients lived in areas characterized by more widespread poverty (20.8% vs 11.1%; P = .0003), lower income ($42,776 vs $65,193; P = .0007), and fewer residents with a high school diploma (73.7% vs 90.1%; P < .0001). Compared with patients whose index operation was elective, patients who had urgent or emergency index procedures lived in areas with lower income ($54,425 vs $64,846; P = .01) and fewer residents with a high school diploma (81.1% vs 89.2%; P = .005). Community socioeconomic factors did not differ by gender. Four- and 6-year survival estimates were 63.1% and 63.1% for Black patients versus 89.1% and 83.0% for White patients (P = .0009). No significant differences by acuity or gender were found., Conclusions: Among readmitted patients, Black patients and patients who had emergency surgery had less favorable community socioeconomic factors and poorer long-term survival. Earlier and more frequent follow-up in these patients should be considered. Developing off-campus clinics and specific postdischarge measures targeting these patients is important., Competing Interests: Conflict of Interest Statement Dr Preventza is a consultant for Terumo Aortic, W.L. Gore & Associates, Abiomed, and Intressa. Dr Chatterjee has served on advisory boards for Edwards Lifesciences, La Jolla Pharmaceutical, Baxter Pharmaceuticals, and Eagle Pharmaceuticals. Dr Moon serves on the advisory boards of Medtronic and Edwards Lifesciences. Dr Coselli serves as principal investigator for, consults for, and receives royalties and a departmental educational grant from Terumo Aortic; consults and participates in clinical trials for Medtronic Inc, and W.L. Gore & Associates; and participates in clinical trials for Abbott Laboratories, CytoSorbents, Edwards Lifesciences, and Artivion. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Objective: Many patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair have had a previous myocardial infarction (MI). To address the paucity of data regarding outcomes in such patients, we aimed to compare outcomes after open TAAA repair in patients with and without previous MI., Methods: From 1986 to 2022, we performed 3737 consecutive open TAAA repairs. Of these, 706 (18.9%) were in patients with previous MI. We used multivariable logistic regression to identify predictors of operative death. Propensity score matching analyzed preoperative and select operative variables to create matched groups of patients with or without a previous MI (n = 704 pairs). Late survival was determined by Kaplan-Meier analysis and compared by log rank test., Results: Overall, operative mortality was 8.5% and the adverse event rate was 15.2%; these were elevated in patients with MI (11.0% vs 7.9% [P = .01] and 18.0% vs 14.6% [P = .02], respectively). In the propensity score-matching cohort, the MI group had a greater rate of cardiac complications (32.4% vs 25.4%; P = .005) and delayed paraparesis (5.1% vs 2.4%; P = .1); however, there was no difference in operative mortality (11.1% vs 10.9%; P = 1) or adverse event rate (18.0% vs 16.8%; P = .6). Overall, previous MI was not independently associated with operative mortality in multivariable analysis (P = .1). The matched MI group trended toward poorer 10-year survival (29.8% ± 1.9% non-MI vs 25.0% ± 1.8% MI; P = .051)., Conclusions: Although previous MI was not associated with early mortality after TAAA repair, patients with a previous MI had greater rates of cardiac complications and delayed paraparesis. Patients with a previous MI also trended toward poorer survival., Competing Interests: Conflict of Interest Statement Dr Moon serves on the advisory boards for Medtronic and Edwards Lifesciences. Dr LeMaire consults for Terumo Aortic and Cerus and serves as a principal investigator for clinical studies sponsored by Terumo Aortic and CytoSorbents. Dr Coselli consults for, receives royalties and a departmental educational grant from, and participates in clinical trials for Terumo Aortic; consults and participates in clinical trials for Medtronic, Inc, and W.L. Gore & Associates; and participates in clinical trials for Abbott Laboratories, CytoSorbents, Edwards Lifesciences, and Artivion. All other authors have nothing to disclose. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2023 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)