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March 3, 2026Journal of Thoracic and Cardiovascular Surgery

The Association between Distressed Community Index and Failure to Rescue after Cardiac Surgery among Medicare Beneficiaries

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Why the study?

Failure to rescue after complications is an important cardiac surgery quality metric, but the impact of socioeconomic status on failure to rescue is less understood.

Does a higher Distressed Communities Index (DCI) increase the risk of failure to rescue (FTR) after cardiac surgery among Medicare beneficiaries?

Population

67,386 Medicare beneficiaries undergoing coronary and/or valve surgery between 2016 and 2019

Comparison

Distressed Communities Index quintiles or per 10-point increase

Design

Retrospective cohort study

Authors

JPJ. PeguesMichigan MedicineSRSanjhai L. RamdeenGeisinger Medical CenterLRLindsay RoystonSpelman College

Discussion

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Implication

Socioeconomic distress may warrant closer monitoring to improve rescue after cardiac surgery; extends evidence on community factors in FTR.

Key Points

  • Failure to rescue rates were notably associated with the distressed community index, indicating a link between community factors and surgical outcomes.
  • A statistically significant relationship was noted, with a higher distressed community index correlating with increased failure to rescue cases.
  • The analysis assessed Medicare beneficiaries post-cardiac surgery across various communities to identify health outcome differentials based on socioeconomic status.
  • Findings highlight the need for healthcare strategies that address community health disparities to improve surgical success rates.

Structured PICO

Does a higher Distressed Communities Index (DCI) increase the risk of failure to rescue (FTR) after cardiac surgery among Medicare beneficiaries?

P
Population
67,386 Medicare beneficiaries undergoing coronary and/or valve surgery between 2016 and 2019. The cohort was 31.6% female, 5.9% Black, and 1.3% Hispanic.
I
Intervention
Higher Distressed Communities Index (DCI) score, a measure of neighborhood economic well-being (evaluated per 10-point increase and by highest quintile)
C
Comparator
Lower Distressed Communities Index (lowest quintile)
O
Outcome
In-hospital failure to rescue (FTR), described as mortality after complicationshard clinical

Living in more economically distressed communities is independently associated with a higher risk of failure to rescue (mortality after complications) following cardiac surgery.

Cite This Study

Pegues et al. (2026) studied this question.

synapsesocial.com/papers/69a765f9badf0bb9e87db180https://doi.org/10.1016/j.jtcvs.2026.01.025
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Also Consider

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