Racial and Ethnic Disparities in Emergency General Surgery Outcomes Among Older Adult Patients

Area of Science:

• Surgery
• Public Health
• Geriatrics

Background:

• Racial and ethnic disparities in emergency general surgery (EGS) are known.
• Disparities in older adults undergoing EGS are less understood.
• This study investigates these disparities in elderly EGS patients.

Purpose of the Study:

• To examine racial and ethnic disparities in clinical outcomes among older adult patients undergoing EGS.
• To identify specific outcomes affected by race and ethnicity in this vulnerable population.

Main Methods:

• Retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Program database (2013-2019).
• Inclusion of EGS patients aged 65 years and older.
• Risk-adjusted multivariable logistic regression to assess the relationship between race/ethnicity and outcomes (mortality, morbidity, readmission, reoperation).

Main Results:

• Non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian patients had lower 30-day mortality odds compared to non-Hispanic White patients.
• NHB patients showed significantly increased odds of overall morbidity and specific complications (sepsis, venous thromboembolism, unplanned intubation).
• Hispanic patients had lower odds of postoperative myocardial infarction and stroke.

Conclusions:

• Older adult minority patients in EGS face higher morbidity rates.
• Paradoxical disparities in mortality were observed, with lower rates in minority groups.
• Further research is crucial to understand and address these disparities and develop targeted interventions.