Praful Ravi1, Akshay Sood, Marianne Schmid, Firas Abdollah, Jesse D Sammon, Maxine Sun, Dane E Klett, Briony Varda, James O Peabody, Mani Menon, Adam S Kibel, Paul L Nguyen, Quoc-Dien Trinh. 1. *Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK †Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI ‡Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA §Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada ¶Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Abstract
OBJECTIVE: To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States. BACKGROUND: Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several types of major cardiac, general, vascular, orthopedic, and cancer surgical procedures. However, recent evidence suggests attenuation of these racial/ethnic differences, particularly at academic institutions. METHODS: We utilized the American College of Surgeons National Surgical Quality Improvement Program database to identify 142,344 patients undergoing one of the 16 major cancer and noncancer surgical procedures between 2005 and 2011. RESULTS: Eighty-five percent of the cohort was white, with black and Hispanic individuals comprising 8% and 4%, respectively. In multivariable analyses, black patients had greater odds of experiencing prolonged length of stay after 10 of the 16 procedures studied (all P < 0.05), though there was no disparity in odds of 30-day mortality after any surgery. Hispanics were more likely to experience prolonged length of stay after 5 surgical procedures (all P < 0.04), and were at greater odds of dying within 30 days after colectomy, heart valve repair/replacement, or abdominal aortic aneurysm repair (all P < 0.03). Fewer disparities were observed for Hispanics, than for black patients, and also for cancer, than for noncancer surgical procedures. CONCLUSIONS: Important racial/ethnic disparities in perioperative outcomes were observed among patients undergoing major cancer and noncancer surgical procedures at American College of Surgeons National Surgical Quality Improvement Program institutions. There were fewer disparities among individuals undergoing cancer surgery, though black patients, in particular, were more likely to experience prolonged length of stay.
OBJECTIVE: To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States. BACKGROUND: Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several types of major cardiac, general, vascular, orthopedic, and cancer surgical procedures. However, recent evidence suggests attenuation of these racial/ethnic differences, particularly at academic institutions. METHODS: We utilized the American College of Surgeons National Surgical Quality Improvement Program database to identify 142,344 patients undergoing one of the 16 major cancer and noncancer surgical procedures between 2005 and 2011. RESULTS: Eighty-five percent of the cohort was white, with black and Hispanic individuals comprising 8% and 4%, respectively. In multivariable analyses, black patients had greater odds of experiencing prolonged length of stay after 10 of the 16 procedures studied (all P < 0.05), though there was no disparity in odds of 30-day mortality after any surgery. Hispanics were more likely to experience prolonged length of stay after 5 surgical procedures (all P < 0.04), and were at greater odds of dying within 30 days after colectomy, heart valve repair/replacement, or abdominal aortic aneurysm repair (all P < 0.03). Fewer disparities were observed for Hispanics, than for black patients, and also for cancer, than for noncancer surgical procedures. CONCLUSIONS: Important racial/ethnic disparities in perioperative outcomes were observed among patients undergoing major cancer and noncancer surgical procedures at American College of Surgeons National Surgical Quality Improvement Program institutions. There were fewer disparities among individuals undergoing cancer surgery, though black patients, in particular, were more likely to experience prolonged length of stay.
Authors: Peter A Soden; Sara L Zettervall; Sarah E Deery; Kakra Hughes; Michael C Stoner; Philip P Goodney; Ageliki G Vouyouka; Marc L Schermerhorn Journal: J Vasc Surg Date: 2017-09-23 Impact factor: 4.268
Authors: Robert S White; Dahniel L Sastow; Licia K Gaber-Baylis; Virginia Tangel; Andrew D Fisher; Zachary A Turnbull Journal: J Racial Ethn Health Disparities Date: 2018-02-12
Authors: Ryan Lamm; Steven N Mathews; Jie Yang; Jihye Park; Mark Talamini; Aurora D Pryor; Dana Telem Journal: J Gastrointest Surg Date: 2017-03-15 Impact factor: 3.452
Authors: Deepak K Pruthi; Hanzhang Wang; Arpan Satsangi; Miguel Cajipe; Kevan Iffrig; Georges M Haidar; Taylor Hicks; Edward Y Sako; Michael A Liss; Wasim H Chowdhury; Ronald Rodriguez; Dharam Kaushik Journal: Can Urol Assoc J Date: 2018-05-14 Impact factor: 1.862
Authors: Akshay Sood; Firas Abdollah; Jesse D Sammon; Kaustav Majumder; Marianne Schmid; James O Peabody; Mark A Preston; Adam S Kibel; Mani Menon; Quoc-Dien Trinh Journal: World J Surg Date: 2015-10 Impact factor: 3.352
Authors: Sook Y Chan; Pasithorn A Suwanabol; Rachelle N Damle; Jennifer S Davids; Paul R Sturrock; W Brian Sweeney; Justin A Maykel; Karim Alavi Journal: J Gastrointest Surg Date: 2016-08-25 Impact factor: 3.452