From the Department of Obstetrics and Gynecology, Oregon Health Science University.
Urogynecology, Legacy Health, Portland, OR.
Urogynecology (Phila). 2024 Nov 1;30(11):906-918. doi: 10.1097/SPV.0000000000001546. Epub 2024 Jul 8.
Racial inequity elevates risk for certain diagnoses and health disparities. Current data show disparities for Black women when comparing open versus minimally invasive hysterectomy. It is unknown if a similar disparity exists in surgical management of pelvic organ prolapse.
The objective of this study was to determine whether racial or ethnic disparities exist for open abdominal versus minimally invasive sacrocolpopexy.
Cross-sectional data of the Healthcare Cost and Utilization Project National Inpatient Sample and the Nationwide Ambulatory Surgery Sample for the year 2019 was used. Bivariate analysis identified demographic and perioperative differences between abdominal versus minimally invasive sacrocolpopexy, which were compared in a multivariable logistic regression.
Forty-one thousand eight hundred thirty-seven patients underwent sacrocolpopexy: 35,820 (85.6%), minimally invasive sacrocolpopexy, and 6,016, (14.4%) abdominal sacrocolpopexy. In an unadjusted analysis, Black patients were more likely to undergo an abdominal sacrocolpopexy compared to non-Hispanic White patients (OR 2.14, 95% CI 1.16-3.92, P <0.01). Hispanic patients were more likely to undergo abdominal sacrocolpopexy compared to non-Hispanic White patients (OR 1.69, 95% CI 1.26-2.26, P <0.001). Other factors associated with abdominal sacrocolpopexy are zip code quartile, payer status, composite comorbidity score, hospital control, and hospital bed size. In the regression model, Black patients remained more likely to undergo abdominal sacrocolpopexy compared to those who identified as White (aOR 2, 95% CI 1.26-3.16, P < 0.003). Hispanic patients were more likely to undergo abdominal sacrocolpopexy compared to those who identified as White (aOR 1.73, 95% CI 1.31-2.28, P < 0.001).
Abdominal sacrocolpopexy was more likely to occur in patients who identified as Black or Hispanic.
种族不平等会增加某些诊断和健康差距的风险。目前的数据显示，在比较开腹和微创子宫切除术时，黑人女性存在差异。目前尚不清楚在盆腔器官脱垂的手术治疗中是否存在类似的差异。
本研究旨在确定在开放式腹部与微创经骶骨阴道固定术之间是否存在种族或民族差异。
使用 2019 年医疗保健成本和利用项目国家住院样本和全国门诊手术样本的横断面数据。二元分析确定了腹部与微创经骶骨阴道固定术之间的人口统计学和围手术期差异，并在多变量逻辑回归中进行了比较。
41837 例患者接受了经骶骨阴道固定术：35820 例（85.6%）为微创经骶骨阴道固定术，6016 例（14.4%）为开腹经骶骨阴道固定术。在未经调整的分析中，与非西班牙裔白人患者相比，黑人患者更有可能接受开腹经骶骨阴道固定术（OR 2.14，95%CI 1.16-3.92，P<0.01）。与非西班牙裔白人患者相比，西班牙裔患者更有可能接受开腹经骶骨阴道固定术（OR 1.69，95%CI 1.26-2.26，P<0.001）。与开腹经骶骨阴道固定术相关的其他因素包括邮政编码四分位数、付款人身份、综合合并症评分、医院控制和医院床位规模。在回归模型中，与白人患者相比，黑人患者仍更有可能接受开腹经骶骨阴道固定术（aOR 2，95%CI 1.26-3.16，P<0.003）。与白人患者相比，西班牙裔患者更有可能接受开腹经骶骨阴道固定术（aOR 1.73，95%CI 1.31-2.28，P<0.001）。
黑人或西班牙裔患者更有可能接受开腹经骶骨阴道固定术。
