Racial Disparities in Partial Nephrectomy Persist Across Hospital Types: Results From a Population-based Cohort

Autor: Shan Dong, Cary P. Gross, Christopher J. Hoimes, Hui Zhu, Jonathan E. Kiechle, Simon P. Kim, Maxine Sun, Sarah Ialacci, Edward E. Cherullo, Quoc-Dien Trinh, Robert Abouassaly, Neal J. Meropol
Rok vydání: 2016
Předmět:
Zdroj: Urology. 90:69-75
ISSN: 0090-4295
DOI: 10.1016/j.urology.2015.10.035
Popis: Objective To assess the national utilization of partial nephrectomy (PN) for T1a renal masses across different racial groups by hospital type. Although clinical guidelines recommend PN for small renal masses (SRMs), racial disparities persist in the use of PN. High-volume and academic hospitals have been associated with greater use of PN for SRMs. However, it is unknown whether racial disparities persist in the use of PN across different types of hospitals. Methods Using the National Cancer Database, we identified patients with localized T1a renal cancer (≤4 cm) from 1998 to 2011. The primary outcome was receipt of PN among patients surgically treated for SRMs. Multivariable logistic regression analyses were used to assess for racial differences in treatment with PN stratified by hospital characteristics. Results Among 118,207 patients diagnosed with clinical T1a renal masses, 36.5% underwent PN (n = 43,134). Overall, a greater proportion of white patients underwent PN (37.3%) compared with African-American (32.4%) and Hispanic (33.7%) patients with SRMs ( P P = .003) and academic (odds ratio: 0.65; P Conclusions In this population-based cohort, we found that racial disparities persist across all types of hospitals in the use of PN for SRMs. Further research is needed to identify, and target for intervention, the factors contributing to racial disparities in the surgical management of SRMs.
Databáze: OpenAIRE
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