Loza-Avalos Sandra E, Isenberg Erin E, Cheng Mingyuan, Fitzgerald Caitlin A, Dumas Ryan P, Tannous Anthony, Butler Dale, Park Caroline
Department of Surgery, UT Southwestern Medical Center, Dallas Texas.
Department of Surgery, UT Southwestern Medical Center, Dallas Texas; National Clinician Scholars Program, University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan.
J Surg Res. 2025 May;309:80-87. doi: 10.1016/j.jss.2025.03.004. Epub 2025 Apr 15.
Living in a food desert may increase the risk of health conditions related to biliary disease, such as obesity. However, there is limited understanding of food deserts' relationship with biliary disease. In this retrospective study, we explored food deserts in our region and examined the relationship between food deserts and biliary severity and outcomes using food census tracts.
We performed a retrospective review of 1609 patients presenting to our urban safety-net hospital that underwent cholecystectomy for acute cholecystitis, acute biliary pancreatitis, and choledocholithiasis between 2020 and 2021. Patients undergoing elective or outpatient cholecystectomy were excluded. Our primary end point was the association between living in a low-income and low-access to food (LILA) census tract and severity of biliary disease. Secondary end points included assessing associations between body mass index (BMI) and 30-d readmission, and geospatial patterns of BMI, severity of disease, and readmission. Statistical tests and the Getis-Ord Global Gi and local G statistic were performed for intergroup differences and geospatial mapping.
The median age was 39 y (29-49); 76% of patients were female, 84% identified as Hispanic, and 8.5% Black. Geospatial hotspots in LILA census tracts were identified and were significant for patients with higher BMI (P < 0.001) but not significant for 30-d readmissions (P = 0.12). Hotspots of patients with greater median disease severity were not in LILA census tracts and were not significant (P = 0.3). Overweight and/or obese patients undergoing cholecystectomy were more likely to reside in LILA census tracts. There was no association with disease severity or readmission and residing in a LILA census tract.
Higher BMI was more prevalent in LILA census tracts in this single-center study. There was no significant association between patient severity of disease and 30-d readmission, but there was overlap between readmission hot spots and LILA census tracts in geospatial analysis. We will continue to explore the relationship between food deserts and our patients' outcomes for targeted interventions to address any disparities.
生活在食物荒漠地区可能会增加患与胆道疾病相关的健康问题的风险，比如肥胖。然而，人们对食物荒漠与胆道疾病之间的关系了解有限。在这项回顾性研究中，我们探索了我们所在地区的食物荒漠，并使用食物普查区来研究食物荒漠与胆道疾病严重程度及预后之间的关系。
我们对2020年至2021年间在我们城市安全网医院因急性胆囊炎、急性胆源性胰腺炎和胆总管结石接受胆囊切除术的1609例患者进行了回顾性研究。排除接受择期或门诊胆囊切除术的患者。我们的主要终点是生活在低收入且食物获取不便（LILA）普查区与胆道疾病严重程度之间的关联。次要终点包括评估体重指数（BMI）与30天再入院率之间的关联，以及BMI、疾病严重程度和再入院率的地理空间模式。进行了统计检验以及Getis-Ord全局Gi和局部G统计以分析组间差异和地理空间映射。
中位年龄为39岁（29 - 49岁）；76%的患者为女性，84%为西班牙裔，8.5%为黑人。在LILA普查区发现了地理空间热点，这些热点在BMI较高的患者中具有统计学意义（P < 0.001），但在30天再入院患者中无统计学意义（P = 0.12）。疾病严重程度中位数较高的患者的热点不在LILA普查区，且无统计学意义（P = 0.3）。接受胆囊切除术的超重和/或肥胖患者更有可能居住在LILA普查区。疾病严重程度或再入院率与居住在LILA普查区之间无关联。
在这项单中心研究中，较高的BMI在LILA普查区更为普遍。患者疾病严重程度与30天再入院率之间无显著关联，但在地理空间分析中，再入院热点与LILA普查区存在重叠。我们将继续探索食物荒漠与我们患者预后之间的关系，以便进行有针对性的干预来解决任何差异。
