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The following is a summary of “County-level Food Insecurity is Associated with Outcomes Following Cardiac Surgery,” published in the August 2024 issue of Surgery by Azap et al.

The existing literature still needs to explore the relationship between food insecurity (FI) and surgical outcomes. This study evaluated how county-level FI influences outcomes following cardiac surgery, specifically coronary artery bypass grafting (CABG).

Researchers conducted a retrospective cohort study using Medicare Standard Analytic Files data for patients who underwent CABG between 2016 and 2020. Patients were categorized based on county-level FI into low, moderate, and high FI cohorts. The primary outcome measure was the achievement of “textbook outcomes,” defined as optimal postoperative results. To assess the association between FI and surgical outcomes, the study group employed adjusted multiple logistic regression and Cox regression models to analyze immediate and long-term outcomes.

The cohort comprised 267,914 patients. Analysis revealed that those residing in high FI regions were significantly less likely to achieve textbook outcomes (OR: 0.94, 95% CI: 0.90-0.99). Specifically, patients from high FI regions exhibited higher odds of 90-day mortality (OR: 1.24, 95% CI: 1.12-1.36) and longer hospital stays (OR: 1.07, 95% CI: 1.01-1.14), with all results showing statistical significance (p < 0.0001). Furthermore, these patients faced an increased risk of 5-year mortality (HR: 1.11, 95% CI: 1.06-1.17) compared to those from low FI regions. Racial disparities were evident, as Black patients in high FI areas had a higher risk of 5-year mortality (HR: 1.27, 95% CI: 1.17-1.38, p < 0.0001) relative to White patients within the same FI category.

The study highlights a significant association between county-level FI and poorer outcomes following cardiac surgery. Patients from high FI regions experienced lower rates of optimal postoperative results, increased mortality, and extended hospital stays. Additionally, racial disparities in outcomes were noted, with Black patients in high FI regions facing disproportionately worse long-term mortality. These findings underscore the need for targeted interventions to address the impact of food insecurity on surgical outcomes and to mitigate associated disparities.

Source: sciencedirect.com/science/article/abs/pii/S0002961024004598