Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery.

Autor: Gunnells DJ Jr; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA., Morris MS; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA., DeRussy A; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA., Gullick AA; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA., Malik TA; Division of Gastroenterology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA., Cannon JA; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA., Hawn MT; Department of Surgery, Stanford University, Stanford, CA, USA., Chu DI; Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, KB427, 1720 2nd Avenue South, UAB, Birmingham, AL, 35294-0016, USA. dchu@uab.edu.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2016 May; Vol. 20 (5), pp. 985-93. Date of Electronic Publication: 2016 Jan 07.
DOI: 10.1007/s11605-015-3068-9
Abstrakt: Background: The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery.
Design: The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression.
Results: Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 % were readmitted within 30 days of index operation. Black patients constituted 7.7 % of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 %) and Crohn's diagnosis (84 vs. 73 %) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 %) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 % confidence interval 1.1-2.5).
Conclusions: Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.
Databáze: MEDLINE
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