Brown Oluwateniola, Mou Tsung, Kenton Kimberly, Sheyn David, Bretschneider C Emi
Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, 250 E Superior Street, Suite 05-2370, Chicago, IL, 60611, USA.
Division of Female Pelvic Medicine and Reconstructive Surgery, Metro Health Medical Center, Cleveland, OH, USA.
Int Urogynecol J. 2022 Feb;33(2):385-395. doi: 10.1007/s00192-021-04726-w. Epub 2021 Mar 23.
The study objective was to examine the impact of race on inpatient complications and costs after inpatient surgery for pelvic organ prolapse (POP).
In this retrospective cohort study, we identified women who underwent surgery for POP between 2012 and 2014. Patient demographics, outcomes, hospital characteristics, and hospital costs were extracted. Demographic and clinical characteristics were compared by race using Kruskal-Wallis for continuous variables and Chi-squared test for categorical variables. Multivariate logistic and linear regressions were used to identify variables associated with increased complications and costs respectively.
A total of 29,347 women with a median age of 62 years underwent inpatient surgery for POP between 2012 and 2014. There were 4,419 women (15%) who had at least one in-hospital postoperative complication. Rates of any postoperative complication were significantly higher among Black women (20%) than among white, Hispanic, and women of other races (16%, 11%, and 13% respectively, p < 0.01). The median total cost associated with surgeries for POP was $8,267 (IQR $6,008-$11,734). After multivariate analyses controlled for potential confounders, postoperative complications remained independently associated with Black race (aOR 1.21) whereas Hispanic and other races were associated with decreased odds of complications (aOR 0.62, and aOR 0.77) relative to white race. After controlling for confounders, Hispanic women had lower associated hospital costs.
Black women undergoing inpatient surgery for POP had a 21% increase in the odds of complications, but no difference in costs compared with white women, whereas Hispanic women had the lowest odds of complications and lowest costs.
本研究的目的是探讨种族对盆腔器官脱垂（POP）住院手术后住院并发症及费用的影响。
在这项回顾性队列研究中，我们确定了2012年至2014年间接受POP手术的女性。提取了患者的人口统计学信息、手术结果、医院特征及住院费用。使用Kruskal-Wallis检验对连续变量按种族比较人口统计学和临床特征，使用卡方检验对分类变量进行比较。分别采用多因素逻辑回归和线性回归来确定与并发症增加和费用增加相关的变量。
2012年至2014年间，共有29347名中位年龄为62岁的女性接受了POP住院手术。其中有4419名女性（15%）至少发生了1例术后住院并发症。黑人女性术后任何并发症的发生率（20%）显著高于白人、西班牙裔及其他种族女性（分别为16%、11%和13%，p<0.01）。POP手术的中位总费用为8267美元（四分位间距6008 - 11734美元）。在对潜在混杂因素进行多因素分析后，术后并发症仍与黑人种族独立相关（调整后比值比1.21），而西班牙裔和其他种族与白人种族相比并发症发生几率降低（调整后比值比0.62和0.77）。在控制混杂因素后，西班牙裔女性的住院相关费用较低。
接受POP住院手术的黑人女性并发症发生几率增加21%，但与白人女性相比费用无差异，而西班牙裔女性并发症发生几率最低且费用最低。
