Symptomatic Cholelithiasis: Do Minority Patients Experience Delays to Surgery?

Area of Science:

• Surgical outcomes research
• Health disparities
• Gastrointestinal surgery

Background:

• Cholecystectomy is a common surgery, often for symptomatic cholelithiasis (SC).
• Delays in care can escalate SC cases to urgent surgeries, potentially increasing complications.
• This study investigates disparities in urgent cholecystectomy rates and outcomes among minority patients.

Purpose of the Study:

• To determine if minority patients with SC experience higher rates of urgent cholecystectomy.
• To assess if urgent cholecystectomy is associated with increased postoperative complications.
• To identify potential treatment disparities in surgical care for SC.

Main Methods:

• Analysis of 13,390 patients undergoing cholecystectomy for SC (2017-2019) from the ACS NSQIP database.
• Primary outcome: acuity of surgery (urgent vs. elective).
• Secondary outcomes: postoperative complications and length of stay.

Main Results:

• Hispanic and non-Hispanic Black patients had significantly higher odds of urgent cholecystectomy compared to non-Hispanic White patients.
• Urgent surgery was linked to greater odds of postoperative complications and extended hospital stays.
• After adjusting for urgency, Black and Asian patients faced longer postoperative lengths of stay.

Conclusions:

• Hispanic and non-Hispanic Black patients are disproportionately undergoing urgent cholecystectomies for SC.
• Urgent surgery independently increases complication rates and length of stay.
• Further research into surgical care delays is essential to mitigate these health disparities.