Racial Disparities in Surgical Outcomes of Acute Diverticulitis: Have We Moved the Needle?

Area of Science:

• Surgical outcomes research
• Health equity studies
• Gastrointestinal surgery

Background:

• Healthcare disparities in surgical outcomes, particularly for Black patients with diverticulitis, have been noted.
• Despite national initiatives to improve health equity, a re-evaluation of these disparities is needed.

Purpose of the Study:

• To assess the association between race and short-term outcomes in patients undergoing surgery for acute diverticulitis.
• To evaluate racial differences in surgical approaches for acute diverticulitis.

Main Methods:

• Analysis of the National Surgical Quality Improvement Program database (2015-2019).
• Inclusion of patients undergoing nonelective surgery for acute diverticulitis.
• Comparison of disease severity, morbidity, mortality, surgical approach, and ostomy creation by race using multivariate logistic regression.

Main Results:

• Black race was independently linked to higher 30-day morbidity (OR: 1.24, P=0.003).
• Native Hawaiian/Pacific Islander race was independently linked to higher 30-day mortality (OR: 5.35, P=0.019).
• No significant racial differences were found in complicated disease, use of laparoscopy, or ostomy creation.

Conclusions:

• Healthcare disparities in surgical outcomes for diverticulitis persist despite national equity efforts.
• Black and Native Hawaiian/Pacific Islander patients face higher morbidity and mortality, respectively.
• The absence of racial disparities in laparoscopic surgery use suggests potential progress in closing some equity gaps.