Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
Am J Surg. 2021 Jul;222(1):153-158. doi: 10.1016/j.amjsurg.2020.11.025. Epub 2020 Dec 1.
Few studies examine the impact of ethnicity on post-operative outcomes and costs associated with pancreaticoduodenectomy (PD).
Multivariable regression (MVR) was used to perform a risk-adjusted comparison of patients within the Healthcare Cost and Utilization Project Databases undergoing PD.
4742 patients underwent PD. 3871 (81%) were white, 456 (10%) black, and 415 (9%) Hispanic. Black and Hispanics were less likely than whites to undergo PD in high volume centers. Blacks and Hispanics had a higher risk of select post-operative complications, prolonged lengths of stay, and high-cost outliers. When PDs done in high volume centers were evaluated separately, blacks and Hispanics had a lower adjusted-risk of any serious morbidity (OR 0.44, 95% CI [0.33, 0.57], OR 0.56, 95% CI [0.43, 0.73]) than whites but costs for PD among the three ethnic groups were statistically identical.
Racial and ethnic minorities undergoing PD are less likely to receive care at high-volume centers, are at an increased risk of post-operative morbidity, and have higher odds of being high-cost outliers than NHW.
很少有研究探讨种族对胰十二指肠切除术（PD）相关术后结果和成本的影响。
使用多变量回归（MVR）对 Healthcare Cost and Utilization Project Databases 中接受 PD 的患者进行风险调整比较。
4742 名患者接受了 PD 手术。3871 名（81%）为白人，456 名（10%）为黑人，415 名（9%）为西班牙裔。与白人相比，黑人及西班牙裔更不可能在高容量中心接受 PD 手术。黑人及西班牙裔发生某些特定术后并发症、住院时间延长和高费用离群值的风险更高。当分别评估在高容量中心进行的 PD 时，黑人及西班牙裔发生任何严重发病率的调整后风险低于白人（OR 0.44，95%CI [0.33, 0.57]，OR 0.56，95%CI [0.43, 0.73]），但这三个种族群体的 PD 成本在统计学上是相同的。
接受 PD 的少数族裔患者不太可能在高容量中心接受治疗，术后发病率较高，且成为高费用离群值的可能性高于非西班牙裔白人。
