Racial disparities in early postoperative proximal humerus fracture outcomes: Do minorities face longer operative times, extended hospital stays, and higher risks?
| Autor: | Kishan A; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Zhu AR; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Zhu S; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Moon GS; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Kishan A; Department of Computer Engineering, K.J. Somaiya Institute of Technology, Mumbai, India., Suresh SJ; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Best MJ; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA., Srikumaran U; Department of Orthopaedic Surgery, Division of Shoulder Surgery, The Johns Hopkins University, Columbia, MD, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Shoulder & elbow [Shoulder Elbow] 2024 Nov 22, pp. 17585732241299052. Date of Electronic Publication: 2024 Nov 22. |
| DOI: | 10.1177/17585732241299052 |
| Abstrakt: | Background: Racial disparities in orthopedic surgery outcomes have been extensively documented, highlighting systemic biases in care. Proximal humerus fractures (PHFs), about 6% of all fractures, are rising, especially among the elderly. Despite the prevalence of PHFs, a research gap exists regarding racial disparities in postoperative complications and outcomes. Methods: Data from the American College of Surgeons NSQIP database from 2006 to 2021 were analyzed, including 41,285 patients with PHFs. CPT and ICD codes guided inclusion and exclusion criteria. Propensity-score matching balanced a cohort of 17,052 patients. Demographic variables, comorbidities, and outcomes were analyzed using univariate statistics, chi-square tests, and Fisher's exact tests. Results: Post propensity-score matching, significant demographic disparities emerged between white and minority patients. Minority patients had longer operative times ( p < .001) and hospital stays ( p = .001) than white patients. Minority patients also exhibited higher rates of mortality ( p = .04) and unplanned re-intubation ( p = .04). Conclusion: This study revealed significant racial disparities in early postoperative outcomes for PHFs. Despite surgical advancements, minorities have prolonged operative times, extended hospital stays, and heightened risks of adverse events. Action is needed to ensure healthcare equity and justice and to address disparities in PHF surgical management across diverse demographics. Level of Evidence: III. Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Matthew J. Best: Arthrex, Inc: Other financial or material support; Smith & Nephew: Other financial or material support; Stryker: Other financial or material support; not related to the present study. Dr. Srikumaran serves as a board or committee member for AAOS, American Shoulder and Elbow Surgeons, and IASES; reports stock or stock options from ROM3, Sonogen, and Tigon Medical; is a paid consultant for, and receives intellectual property royalties from, Fx Shoulder and Tigon Medical; receives other financial or material support from Arthrex, DePuy–a Johnson & Johnson Company, and Thieme; and has been a paid presenter or speaker for, and received research support from, Fx Shoulder; not related to the present study. The other authors report no potential conflicts of interest, including financial interests, activities, relationships, and affiliations. (© The Author(s) 2024.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|