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短期尿道悬吊带手术结果中的种族和社会经济差异

Racial and Socioeconomic Disparities in Short-term Urethral Sling Surgical Outcomes.

作者信息

Dallas Kai B, Sohlberg Ericka M, Elliott Christopher S, Rogo-Gupta Lisa, Enemchukwu Ekene

机构信息

Stanford University School of Medicine, Stanford, CA.

Stanford University School of Medicine, Stanford, CA.

出版信息

Urology. 2017 Dec;110:70-75. doi: 10.1016/j.urology.2017.08.021. Epub 2017 Aug 25.

Abstract

OBJECTIVE

To evaluate the association of racial and socioeconomic factors with the risk of adverse events in the first 30 days following urethral sling placement.

METHODS

We accessed nonpublic data from the Office of Statewide Health Planning and Development in California from 2005 to 2011. All female patients who underwent an ambulatory urethral sling procedure in the entire state of California over the study period were identified (Current Procedural Terminology 57288). Our main outcome was any unplanned hospital visits within 30 days of the patient's surgery in the form of an inpatient admission, revision surgery, or emergency department visit.

RESULTS

A total of 28,635 women who underwent outpatient urethral sling placement were identified. Within 30 days, 1628 women (5.7%) had at least 1 unplanned hospital visit. In the adjusted multivariate model, black race and Medicaid insurance status were both independently associated with increased odds of having an unplanned hospital visit (odds ratio 1.80, P < .01 and odds ratio 1.53, P < .01, respectively). This significance persisted even when controlling for patient comorbidities, demographics, and facility characteristics.

CONCLUSION

We found that, similar to what has been reported in other fields, disparities in outcomes exist between socioeconomic and racial groups in the field of urogynecology.

摘要

目的

评估种族和社会经济因素与尿道悬吊带置入术后30天内不良事件风险之间的关联。

方法

我们获取了加利福尼亚州全州卫生规划与发展办公室2005年至2011年的非公开数据。确定了研究期间在加利福尼亚州全州接受门诊尿道悬吊带手术的所有女性患者(当前程序编码57288)。我们的主要结局是以住院、翻修手术或急诊就诊形式在患者手术后30天内进行的任何非计划内医院就诊。

结果

共确定了28635名接受门诊尿道悬吊带置入术的女性。在30天内,1628名女性(5.7%)至少有1次非计划内医院就诊。在调整后的多变量模型中,黑人种族和医疗补助保险状态均与非计划内医院就诊几率增加独立相关(优势比分别为1.80,P <.01和优势比1.53,P <.01)。即使在控制患者合并症、人口统计学和机构特征后,这种显著性仍然存在。

结论

我们发现,与其他领域所报道的情况类似,在泌尿妇科领域,社会经济和种族群体之间存在结局差异。

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