Owusu-Agyemang Pascal, Idowu Olakunle, Muthukumar Arun, Guerra-Londono Juan Jose, Idowu Techecia, Diaz Nancy N, Feng Lei, Miller Malachi, Gundre Satvik, Wright Crystal, Cata Juan P
From the Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Anesthesiology and Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Anesth Analg. 2025 Aug 1;141(2):276-285. doi: 10.1213/ANE.0000000000007135. Epub 2024 Aug 23.
Racial and ethnic differences in health care may result in significant morbidity. The objective of this study was to determine whether there was an association between a patient's race or ethnicity and the receipt of an antiemetic agent preoperatively, during surgery, and in the recovery room.
A single-institution retrospective study of adult patients (>18 years) who had undergone cancer-related operating room procedures under anesthesia between March 2016 and August 2021 was conducted. A multivariable logistic regression model was fitted to estimate the effects of covariates on antiemetic administration.
Of the 60,595 patients included in the study, 3053 (5.0%) self-identified as Asian, 5376 (8.9%) as Black, 8431 (13.9%) as Hispanic or Latino, 42,533 (70.2%) as White, and 1202 (2.0%) as belonging to another racial or ethnic group. Multivariable analyses showed significant associations between a patient's race or ethnicity and the receipt of antiemetics in the preoperative holding area, operating room, and recovery room (all P < .001). In the preoperative holding area, White patients (8962 of 42,533 [21.1%]; odds ratio [OR], 1.188; 95% confidence interval [CI], 1.100-1.283; P < .001) had higher odds of receiving an antiemetic than Black patients (1006 of 5376 [18.7%]). Intraoperatively, the odds were significantly greater for Hispanic or Latino (7323 of 8431 [86.9%]; OR, 1.175; 95% CI, 1.065-1.297; P = .001) and patients who identified as belonging to another race (1078 of 1202 [89.7%]; OR, 1.582; 95% CI, 1.290-1.941; P < .001) than for Black patients (4468 of 5376 [83.1%]). In the recovery room, Asian (499 of 3053 [16.3%]; OR, 1.328; 95% CI: 1.127-1.561; P < .001), Hispanic or Latino (1335 of 8431 [15.8%]; OR, 1.208; 95% CI, 1.060-1.377; P < .005), and White patients (6533 of 42,533 [15.4%]; OR, 1.276; 95% CI, 1.140-1.427; P < .001) had significantly higher odds of receiving antiemetics than Black patients (646 of 5376 [12%]).
This retrospective study suggests significant differences between the administrations of antiemetics to patients of different races or ethnicities, with Black patients often being less likely to receive an antiemetic than patients belonging to all other races or ethnicities.
医疗保健中的种族和族裔差异可能导致显著的发病率。本研究的目的是确定患者的种族或族裔与术前、手术期间及恢复室使用止吐药之间是否存在关联。
对2016年3月至2021年8月期间在麻醉下接受癌症相关手术室手术的成年患者（>18岁）进行单机构回顾性研究。采用多变量逻辑回归模型来估计协变量对止吐药使用的影响。
在纳入研究的60595例患者中，3053例（5.0%）自我认定为亚洲人，5376例（8.9%）为黑人，8431例（13.9%）为西班牙裔或拉丁裔，42533例（70.2%）为白人，1202例（2.0%）属于其他种族或族裔群体。多变量分析显示，患者的种族或族裔与术前等候区、手术室及恢复室使用止吐药之间存在显著关联（所有P<.001）。在术前等候区，白人患者（42533例中的8962例[21.1%]；比值比[OR]，1.188；95%置信区间[CI]，1.100 - 1.283；P<.001）使用止吐药的几率高于黑人患者（5376例中的1006例[18.7%]）。术中，西班牙裔或拉丁裔患者（8431例中的7323例[86.9%]；OR，1.175；95%CI，1.065 - 1.297；P =.001）以及自我认定为其他种族的患者（1202例中的1078例[89.7%]；OR，1.582；95%CI，1.290 - 1.941；P<.001）使用止吐药的几率显著高于黑人患者（5376例中的4468例[83.1%]）。在恢复室，亚洲患者（3053例中的499例[16.3%]；OR，1.328；95%CI：1.127 - 1.561；P<.001）、西班牙裔或拉丁裔患者（8431例中的1335例[15.8%]；OR，1.208；95%CI，1.060 - 1.377；P<.005）以及白人患者（42533例中的6533例[15.4%]；OR，1.276；95%CI，1.140 - 1.427；P<.001）使用止吐药的几率显著高于黑人患者（5376例中的646例[12%]）。
这项回顾性研究表明，不同种族或族裔患者在使用止吐药方面存在显著差异，黑人患者使用止吐药的可能性通常低于所有其他种族或族裔的患者。
