Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.
Am J Surg. 2018 Jun;215(6):1046-1050. doi: 10.1016/j.amjsurg.2018.05.011. Epub 2018 May 12.
Inflammatory Bowel Disease (IBD) has not historically been a focus of racial health disparities research. IBD has been increasing in the black community. We hypothesized that outcomes following surgery would be worse for black patients.
A retrospective cohort study of death and serious morbidity (DSM) of patients undergoing surgery for IBD was performed using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP 2011-2014). Multivariable logistic regression modeling was performed to evaluate associations between race and outcomes.
Among 14,679 IBD patients, the overall rate of DSM was 20.3% (white: 19.3%, black 27.0%, other 23.8%, p < 0.001). After adjustment, black patients remained at increased risk of DSM compared white patients (OR: 1.37; 95% CI 1.14-1.64).
Black patients are at increased risk of post-operative DSM following surgery for IBD. The elevated rates of DSM are not explained by traditional risk factors like obesity, ASA class, emergent surgery, or stoma creation.
炎症性肠病（IBD）在历史上并不是种族健康差异研究的重点。IBD 在黑人社区的发病率一直在上升。我们假设黑人患者手术后的结果会更差。
本研究采用美国外科医师学会国家手术质量改进计划（NSQIP，2011-2014 年）的数据，对因 IBD 接受手术的患者的死亡和严重并发症（DSM）进行了回顾性队列研究。采用多变量逻辑回归模型来评估种族与结局之间的关系。
在 14679 例 IBD 患者中，DSM 的总体发生率为 20.3%（白人：19.3%，黑人：27.0%，其他：23.8%，p<0.001）。调整后，与白人患者相比，黑人患者仍存在 DSM 风险增加的情况（OR：1.37；95%CI 1.14-1.64）。
黑人患者在因 IBD 接受手术后发生术后 DSM 的风险增加。DSM 发生率的升高不能用肥胖、ASA 分级、急诊手术或造口术等传统危险因素来解释。
