Timothy Feeney1, Sabrina Elena Sanchez2, Yorghos Tripodis3, Tejal Sudhirkumar Brahmbhatt2, Robert Schulze2, Peter Burke2, Tracey Dechert2, Frederick Thurston Drake4. 1. Department of Surgery, Boston Medical Center, Boston Massachusetts; Division of Acute Care and Trauma Surgery, Boston Medical Center, Boston Massachusetts. Electronic address: timothy.feeney@bmc.org. 2. Department of Surgery, Boston Medical Center, Boston Massachusetts; Division of Acute Care and Trauma Surgery, Boston Medical Center, Boston Massachusetts. 3. Department of Biostatistics, Boston University School of Public Health, Boston Massachusetts. 4. Department of Surgery, Boston Medical Center, Boston Massachusetts; Division of Surgical Endocrinology, Boston Medical Center, Boston Massachusetts.
Abstract
BACKGROUND: Emergency general surgery (EGS) represents a diverse set of operations performed on acutely ill patients. Those undergoing EGS are at higher likelihood of complications, readmission, and death, but the effect of primary language on EGS outcomes has not been evaluated. We aimed to evaluate the association of non-English primary language on outcomes after EGS operations. METHODS: The New Jersey Statewide Inpatient Database from 2009 to 2014 was used to evaluate cases representing 80% of the national burden of EGS. Cases were restricted to ages ≥18 y, emergency department admissions, noted to be emergent or urgent, and performed between 0 and 2 d after admission. We evaluated Spanish speakers and non-English, non-Spanish (NENS) speakers compared with English. Outcomes included in-hospital mortality, 7-d readmission, and hospital length of stay (LOS). Logistic and negative binomial regression was used, and generalized linear mixed models were used to account for hierarchy in the data. RESULTS: There were 105,171 patients included. English speakers were majority white and with private insurance; Spanish speakers were younger and with fewer comorbidities. Where differences between Spanish and NENS speakers existed, NENS were more like the English-speaking group. Adjusted results indicate that Spanish speakers had reduced LOS after appendectomy (IRR: 0.92 [0.89-0.95]) and lysis of adhesion [0.93 (0.88-0.97)]. Spanish speakers had an increased LOS after higher risk operations (IRR: 1.14 [1.10-1.20]). NENS speakers had a reduced LOS after adhesiolysis (IRR: 0.94 [0.89-0.99]). There was no difference in mortality or short-term readmission CONCLUSIONS: These data from a large database suggest that the effect of primary language on LOS after EGS depends on the type of operation. Future studies should focus on long-term outcomes and determining if the lack of association we observed is generalizable to other regions of the United States.
BACKGROUND: Emergency general surgery (EGS) represents a diverse set of operations performed on acutely ill patients. Those undergoing EGS are at higher likelihood of complications, readmission, and death, but the effect of primary language on EGS outcomes has not been evaluated. We aimed to evaluate the association of non-English primary language on outcomes after EGS operations. METHODS: The New Jersey Statewide Inpatient Database from 2009 to 2014 was used to evaluate cases representing 80% of the national burden of EGS. Cases were restricted to ages ≥18 y, emergency department admissions, noted to be emergent or urgent, and performed between 0 and 2 d after admission. We evaluated Spanish speakers and non-English, non-Spanish (NENS) speakers compared with English. Outcomes included in-hospital mortality, 7-d readmission, and hospital length of stay (LOS). Logistic and negative binomial regression was used, and generalized linear mixed models were used to account for hierarchy in the data. RESULTS: There were 105,171 patients included. English speakers were majority white and with private insurance; Spanish speakers were younger and with fewer comorbidities. Where differences between Spanish and NENS speakers existed, NENS were more like the English-speaking group. Adjusted results indicate that Spanish speakers had reduced LOS after appendectomy (IRR: 0.92 [0.89-0.95]) and lysis of adhesion [0.93 (0.88-0.97)]. Spanish speakers had an increased LOS after higher risk operations (IRR: 1.14 [1.10-1.20]). NENS speakers had a reduced LOS after adhesiolysis (IRR: 0.94 [0.89-0.99]). There was no difference in mortality or short-term readmission CONCLUSIONS: These data from a large database suggest that the effect of primary language on LOS after EGS depends on the type of operation. Future studies should focus on long-term outcomes and determining if the lack of association we observed is generalizable to other regions of the United States.
Authors: Alison P Woods; Marianna V Papageorge; Susanna W L de Geus; Andrea Alonso; Andrea Merrill; Michael R Cassidy; Daniel S Roh; Teviah E Sachs; David McAneny; Frederick Thurston Drake Journal: Ann Surg Oncol Date: 2022-08-06 Impact factor: 4.339
Authors: Alison P Woods; Andrea Alonso; Swetha Duraiswamy; Carl Ceraolo; Timothy Feeney; Christine M Gunn; William R Burns; Dorry L Segev; F Thurston Drake Journal: J Gen Intern Med Date: 2022-02-02 Impact factor: 6.473