Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients
Background:. This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics. Methods:. In a registry-based cohort study using t...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-09-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000467 |
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| author | Dany Y. Matar, BA Samuel Knoedler Anthony Y. Matar, BS Sarah Friedrich, PhD Harriet Kiwanuka, MD Ryoko Hamaguchi, MD Carla M. Hamwi, BS Gabriel Hundeshagen, MD, MMS Valentin Haug, MD Ulrich Kneser, MD, PhD Keisha Ray, PhD Dennis P. Orgill, MD, PhD Adriana C. Panayi, MD, PhD |
| author_facet | Dany Y. Matar, BA Samuel Knoedler Anthony Y. Matar, BS Sarah Friedrich, PhD Harriet Kiwanuka, MD Ryoko Hamaguchi, MD Carla M. Hamwi, BS Gabriel Hundeshagen, MD, MMS Valentin Haug, MD Ulrich Kneser, MD, PhD Keisha Ray, PhD Dennis P. Orgill, MD, PhD Adriana C. Panayi, MD, PhD |
| author_sort | Dany Y. Matar, BA |
| collection | DOAJ |
| description | Background:. This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics.
Methods:. In a registry-based cohort study using the 2008 to 2020 American College of Surgeons National Surgical Quality Improvement Program, we evaluated 24 postoperative outcomes through multivariable analysis, incorporating 28 preoperative risk factors. In a separate, independent analysis of the 2019 to 2020 National Health Interview Survey (NHIS) database, we examined sociodemographic racial/ethnic normative data.
Results:. Among 7,504,734 American College of Surgeons National Surgical Improvement Database patients specifying race, 83.8% were White (WT), 11.8% Black or African American (B/AA), 3.3% Asian (AS), 0.7% American Indian or Alaska Native (AI/AN), 0.4% Native Hawaiian or Pacific Islander (NH/PI), 7.3% Hispanic. Reoperation trends reveal favorable outcomes for WT, AS, and NH/PI patients compared with B/AA and AI/AN patients. AI/AN patients exhibit higher rates of wound healing issues, while AS patients experience lower rates. AS and B/AA patients are more prone to transfusions, with B/AA patients showing elevated rates of pulmonary embolism, deep vein thrombosis, renal failure, and insufficiency. Disparities in discharge destinations exist. Hispanic patients fare better than non-WT Hispanic patients, contingent on race. Racial groups (excluding Hispanic patients) with superior surgical outcomes from the NSQIP analysis were found in the NHIS analysis to report higher wealth, better healthcare access, improved food security, greater functional and societal independence, and lower frailty.
Conclusions:. Our study underscores racial disparities in surgical outcomes. Focused investigations into these complications could reveal underlying causes, informing healthcare policies to enhance surgical care universally. |
| format | Article |
| id | doaj-art-3cbdb08a80fd413c82555d17c87f338c |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-3cbdb08a80fd413c82555d17c87f338c2025-01-24T09:18:48ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-09-0153e46710.1097/AS9.0000000000000467202409000-00019Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million PatientsDany Y. Matar, BA0Samuel Knoedler1Anthony Y. Matar, BS2Sarah Friedrich, PhD3Harriet Kiwanuka, MD4Ryoko Hamaguchi, MD5Carla M. Hamwi, BS6Gabriel Hundeshagen, MD, MMS7Valentin Haug, MD8Ulrich Kneser, MD, PhD9Keisha Ray, PhD10Dennis P. Orgill, MD, PhD11Adriana C. Panayi, MD, PhD12* From the Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA‡ Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany§ School of Data Science, University of Virginia, Charlottesville, VA‖ Department of Mathematical Statistics and Artificial Intelligence in Medicine, University of Augsburg, Augsburg, Germany* From the Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA* From the Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA¶ Department of Biology, Saint Louis University, St. Louis, MO# Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany# Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany# Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany** Center for Humanities and Ethics, University of Texas Health Science Center, Houston, TX.* From the Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA* From the Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MABackground:. This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics. Methods:. In a registry-based cohort study using the 2008 to 2020 American College of Surgeons National Surgical Quality Improvement Program, we evaluated 24 postoperative outcomes through multivariable analysis, incorporating 28 preoperative risk factors. In a separate, independent analysis of the 2019 to 2020 National Health Interview Survey (NHIS) database, we examined sociodemographic racial/ethnic normative data. Results:. Among 7,504,734 American College of Surgeons National Surgical Improvement Database patients specifying race, 83.8% were White (WT), 11.8% Black or African American (B/AA), 3.3% Asian (AS), 0.7% American Indian or Alaska Native (AI/AN), 0.4% Native Hawaiian or Pacific Islander (NH/PI), 7.3% Hispanic. Reoperation trends reveal favorable outcomes for WT, AS, and NH/PI patients compared with B/AA and AI/AN patients. AI/AN patients exhibit higher rates of wound healing issues, while AS patients experience lower rates. AS and B/AA patients are more prone to transfusions, with B/AA patients showing elevated rates of pulmonary embolism, deep vein thrombosis, renal failure, and insufficiency. Disparities in discharge destinations exist. Hispanic patients fare better than non-WT Hispanic patients, contingent on race. Racial groups (excluding Hispanic patients) with superior surgical outcomes from the NSQIP analysis were found in the NHIS analysis to report higher wealth, better healthcare access, improved food security, greater functional and societal independence, and lower frailty. Conclusions:. Our study underscores racial disparities in surgical outcomes. Focused investigations into these complications could reveal underlying causes, informing healthcare policies to enhance surgical care universally.http://journals.lww.com/10.1097/AS9.0000000000000467 |
| spellingShingle | Dany Y. Matar, BA Samuel Knoedler Anthony Y. Matar, BS Sarah Friedrich, PhD Harriet Kiwanuka, MD Ryoko Hamaguchi, MD Carla M. Hamwi, BS Gabriel Hundeshagen, MD, MMS Valentin Haug, MD Ulrich Kneser, MD, PhD Keisha Ray, PhD Dennis P. Orgill, MD, PhD Adriana C. Panayi, MD, PhD Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients Annals of Surgery Open |
| title | Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients |
| title_full | Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients |
| title_fullStr | Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients |
| title_full_unstemmed | Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients |
| title_short | Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients |
| title_sort | surgical outcomes and sociodemographic disparities across all races an acs nsqip and nhis multi institutional analysis of over 7 5 million patients |
| url | http://journals.lww.com/10.1097/AS9.0000000000000467 |
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