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Influence of Language Barriers on Postoperative Recovery After Hepatobiliary and Pancreatic Surgery: A Retrospective
Freya Brodersen1, Jana Hinz1, Sinja Friedl2
1Nursing Department of General-, Visceral-, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Background:
Understanding health related information is crucial for informed consent and active participation in surgical care. Language barriers between patients and health care professionals pose the risk of misunderstandings and incomplete information exchange. This can significantly impair the quality of health care. Little is known about the impact of language barriers in hepatobiliary and pancreatic surgery and its consequences for postoperative recovery.
Method:
We performed a retrospective study in a University Medical Center in Germany assessing patients from 2020 to 2023 who underwent hepatobiliary or pancreatic surgery. Primarily we investigated whether length of stay (LOS) differed between patients with and without language barrier. Secondary we examined (Enhanced Recovery After Surgery) ERAS-compliance, preoperative education, postoperative mobilization habits, readmission, mortality, occurrence of complications, and certain postoperative complications between both groups.
Results:
We included 848 patients in our study, 57 (6.5%) patients of whom had a language barrier. The length of stay did not differ significantly between the two groups (12.8 days; (CI 95%: 11.9-13.7) versus 14.4 days; (CI 95%: 11.1-17.7) (p = 0.320). The interpreting service in our cohort was rarely used overall. Patients with language barriers were younger (CI 95%: 46.7-56.7 vs. 59.9-61.9; p = 0.001) and differed in terms of their diagnoses (p = 0.001). We found no differences in ERAS Compliance, complication rate and mortality. Among secondary outcomes, patients with language barriers showed higher rates of specific postoperative complications, including pulmonary embolism (p = 0.026), and paralytic ileus (p = 0.047). Patients without language barriers were more likely to be mobilized on day of surgery (p = 0.009) and received preoperative ERAS-education more frequently (p = 0.035).
Conclusion:
Patients experiencing language barriers constitute a small group. Length of stay did not differ between the two groups. However, with respect to postoperative complications further investigation with larger patient cohorts is needed. Our findings emphasize the need for additional research and development of practical and patient-centered strategies to effectively address language barriers in clinical care.
