Racial Disparities in General Surgery Outcomes

Area of Science:

• Health Services Research
• Surgical Outcomes
• Health Disparities

Background:

• Existing research on racial disparities in general surgery outcomes primarily focuses on Black and Hispanic/Latino populations.
• These analyses often exclude other minority groups, such as Asian, American Indian or Alaskan Native (AIAN), and Native Hawaiian or Pacific Islander patients, limiting a comprehensive understanding of surgical equity.

Purpose of the Study:

• To investigate and compare general surgery outcomes across diverse racial and ethnic groups.
• To identify specific adverse outcomes associated with different racial and ethnic categories in the National Surgical Quality Improvement Program (NSQIP) database.

Main Methods:

• Utilized data from the National Surgical Quality Improvement Program (NSQIP) for general surgery procedures performed between 2017 and 2020.
• Employed multivariable regression models to analyze the impact of race and ethnicity on 30-day mortality, readmission, reoperation, major/minor complications, and non-home discharge.
• Calculated adjusted odds ratios (AOR) and 95% confidence intervals to quantify disparities.

Main Results:

• Black patients exhibited higher odds of readmission and reoperation compared to non-Hispanic White patients.
• Hispanic and Latino patients showed increased odds of major and minor complications.
• American Indian or Alaskan Native (AIAN) patients faced significantly higher odds of mortality, major complications, reoperation, and non-home discharge.
• Native Hawaiian or Pacific Islander patients had lower odds of readmission and non-home discharge.
• Asian patients demonstrated lower odds for all analyzed adverse outcomes.

Conclusions:

• Significant disparities in postoperative outcomes persist for Black, Hispanic/Latino, and AIAN patients compared to non-Hispanic White patients.
• AIAN patients experienced particularly high odds for mortality, major complications, reoperation, and non-home discharge.
• Addressing social determinants of health and implementing policy adjustments are crucial for achieving equitable surgical outcomes for all racial and ethnic groups.