The Impact of Race and Ethnicity in Microvascular Head and Neck Reconstruction Postoperative Outcomes: A Nationwide Data Analysis.

Autor:	Escobar-Domingo MJ; Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Bustos VP, Mahmoud AA, Kim EJ, Miller AS, Foppiani JA, Alvarez AH, Lin SJ, Lee BT
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2024 Oct 01; Vol. 35 (7), pp. 1952-1957. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1097/SCS.0000000000010593
Abstrakt:	Background: Racial and ethnic disparities have been extensively reported across surgical specialties, highlighting existing healthcare inequities. Nevertheless, evidence is lacking regarding their influence on postoperative outcomes after head and neck reconstruction. This study aimed to evaluate the impact of race and ethnicity on postoperative complications in head and neck microvascular reconstruction. Methods: The ACS-NSQIP database was used to identify patients who underwent head and neck microvascular reconstruction between 2012 and 2022. Baseline characteristics were compared based on race (White, non-White) and ethnicity (Hispanic, non-Hispanic). Group differences were assessed using t tests and Fisher Exact tests. Multivariable logistic regression models were constructed to evaluate postoperative complications between the groups. A Cochran-Armitage test was conducted to evaluate the significance of trends over time. Results: A total of 11,373 patients met inclusion criteria. Among them, 9,082 participants reported race, and 9,428 reported ethnicity. Multivariable analysis demonstrated that Hispanic patients were more likely to experience 30-day readmission (OR 6.7; 95% CI, 1.17-38.4; P=0.032) and had an average total length of stay of 5.25 days longer (95% CI, 0.84-9.65; P=0.020) compared with non-Hispanic patients. Additional subgroup analyses revealed higher rates of all readmissions among non-White patients, particularly those indicated by malignancy (OR 1.23; 95% CI, 1.1-1.4; P=0.002). No significant differences were found in mortality, reoperation rates, and operative times between racial and ethnic groups. Conclusions: The findings of this study suggest that ethnicity may be a significant risk factor for readmission in head and neck microvascular reconstruction. However, future studies are needed to further clarify the impact of race and ethnicity on longer postoperative outcomes, particularly in head and neck cancer minorities. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu