The Association Between Hispanic Ethnicity, Cholecystectomy, and Postoperative Mortality
Priyanka Singh1, Noah Z Freundlich2, Gezzer Ortega3
1From the Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Introduction:
Hispanic ethnicity is associated with an increased incidence of gallstone disease. Emergency cholecystectomy has a higher case fatality rate than nonemergency cholecystectomy, yet it remains common. We aimed to determine whether an association exists between Hispanic ethnicity, cholecystectomy type, and mortality.
Methods:
The National Surgical Quality Improvement Program database was queried for cholecystectomy cases from 2005 to 2019. Cases included cholecystectomy type. Primary exposure was Hispanic ethnicity. We compared emergency to outpatient cholecystectomy cases, and unplanned (emergency or urgent) to planned (inpatient elective or outpatient) cholecystectomy cases in Hispanic versus non-Hispanic patients. We then compared mortality for Hispanic to non-Hispanic patients for unplanned and planned cholecystectomies separately.
Results:
In total, 479,543 patients underwent cholecystectomy. Hispanic versus non-Hispanic patients had increased odds of emergency compared to outpatient cholecystectomy (adjusted odds ratio [aOR] 2.32; confidence interval [CI]: 2.26, 2.39). Hispanic patients also had increased odds of unplanned cholecystectomies compared with planned cholecystectomies (aOR: 1.59; CI: 1.56, 1.63). Hispanic patients who underwent unplanned cholecystectomies had a 79% decreased odds of mortality compared to non-Hispanic patients (aOR: 0.21; CI: 0.19, 0.23). Hispanic patients who had planned cholecystectomies had a 65% decreased odds of mortality (aOR: 0.35; CI: 0.33, 0.38) compared with non-Hispanic patients.
Conclusion:
Hispanic patients are more likely than non-Hispanic patients to undergo emergency versus outpatient and unplanned versus planned cholecystectomy. However, Hispanic patients have lower 30-day postoperative mortality after both unplanned and planned cholecystectomies compared to non-Hispanic patients.
