Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
Department of Surgery, University of South Florida, Tampa, FL, USA.
Am J Surg. 2021 Apr;221(4):759-763. doi: 10.1016/j.amjsurg.2020.02.050. Epub 2020 Feb 26.
Few studies evaluate racial disparities in costs and clinical outcomes for patients undergoing distal pancreatectomy (DP).
We queried the Healthcare Cost and Utilization Project State Inpatient Databases to identify patients undergoing DP. Multivariable regression (MVR) was used to evaluate the association between race and postoperative outcomes.
2,493 patients underwent DP; 265 (10%) were black, and 221 (8%) were of Hispanic ethnicity. On MVR, black and Hispanic patients were less likely than whites to undergo surgery in high volume centers (OR 0.53, 95% CI [0.40, 0.71]; OR 0.45, 95% CI [0.32, 0.62]). Black patients had a greater risk of postoperative complication (OR 1.40, 95% CI [1.07, 1.83]), 90-day readmission (OR 1.53, 95% CI [1.15, 2.02]), prolonged length of stay (OR 1.74, 95% CI [1.25-2.44]), and of being a high cost outliers (OR 1.40, 95% CI [1.02, 1.91]) compared to white patients.
Black patients have increased risk of having a postoperative complication, prolonged hospitalization, and of being a high-cost outlier than non-Hispanic whites.
很少有研究评估接受远端胰腺切除术 (DP) 的患者在成本和临床结果方面的种族差异。
我们查询了医疗保健成本和利用项目州住院病人数据库，以确定接受 DP 的患者。多变量回归 (MVR) 用于评估种族与术后结果之间的关联。
2493 名患者接受 DP；265 名（10%）为黑人，221 名（8%）为西班牙裔。在 MVR 中，与白人相比，黑人和西班牙裔患者更不可能在高容量中心接受手术（OR 0.53，95%CI [0.40，0.71]；OR 0.45，95%CI [0.32，0.62]）。黑人患者术后并发症风险更高（OR 1.40，95%CI [1.07，1.83]）、90 天再入院风险更高（OR 1.53，95%CI [1.15，2.02]）、住院时间延长风险更高（OR 1.74，95%CI [1.25-2.44]），并且更有可能成为高成本异常值（OR 1.40，95%CI [1.02，1.91]）比白人患者。
与非西班牙裔白人相比，黑人患者术后并发症、住院时间延长和成为高成本异常值的风险更高。
