Association of Race and Postoperative Outcomes in Patients with Inflammatory Bowel Disease

IF 2.5 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
John J. Newland, Margaret H. Sundel, Kyle W. Blackburn, Roumen Vessilenov, Samuel Eisenstein, Andrea C. Bafford
{"title":"Association of Race and Postoperative Outcomes in Patients with Inflammatory Bowel Disease","authors":"John J. Newland, Margaret H. Sundel, Kyle W. Blackburn, Roumen Vessilenov, Samuel Eisenstein, Andrea C. Bafford","doi":"10.1007/s10620-024-08594-4","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Previous literature suggests that rates of postoperative complications following inflammatory bowel disease (IBD) surgery differ based on race.</p><h3 data-test=\"abstract-sub-heading\">Aims</h3><p>The purpose of this study was to examine the association between race and adverse events and wound complications in patients with IBD.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This was a retrospective cohort study of the American College of Surgeons National Surgery Quality Improvement Program Inflammatory Bowel Disease Collaborative from 2017 to 2022. The data was collected from 15 high-volume IBD centers across the United States. The data was analyzed using crude and multivariable logistic regressions.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>4284 patients were included in the study. Overall rates of adverse events and wound complications were 20.3% and 11.3%, respectively, and did not differ based on race on bivariate analysis. Rates of adverse events were 20.0% vs 24.6% vs 22.1%, p = 0.13 for white, black and other minority subjects, respectively. The adjusted odds of adverse events were higher for black subjects (1.46 [95%CI 1.0–2.1], p = 0.03) compared to white subjects. No difference in adverse events was found between other minority subjects and either black or white subjects (1.29 [0.7–2.3], p = 0.58). Race was not associated with likelihood of wound complications in the final analysis.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>We found that a subset of black patients with IBD continue to experience more adverse events compared to white patients, primarily driven by a higher need for postoperative blood transfusion. Nonetheless, known risk factors, including comorbid conditions, decreased BMI, open surgery, and emergency surgery have a stronger association with postoperative complications than race alone.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Diseases and Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10620-024-08594-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Previous literature suggests that rates of postoperative complications following inflammatory bowel disease (IBD) surgery differ based on race.

Aims

The purpose of this study was to examine the association between race and adverse events and wound complications in patients with IBD.

Methods

This was a retrospective cohort study of the American College of Surgeons National Surgery Quality Improvement Program Inflammatory Bowel Disease Collaborative from 2017 to 2022. The data was collected from 15 high-volume IBD centers across the United States. The data was analyzed using crude and multivariable logistic regressions.

Results

4284 patients were included in the study. Overall rates of adverse events and wound complications were 20.3% and 11.3%, respectively, and did not differ based on race on bivariate analysis. Rates of adverse events were 20.0% vs 24.6% vs 22.1%, p = 0.13 for white, black and other minority subjects, respectively. The adjusted odds of adverse events were higher for black subjects (1.46 [95%CI 1.0–2.1], p = 0.03) compared to white subjects. No difference in adverse events was found between other minority subjects and either black or white subjects (1.29 [0.7–2.3], p = 0.58). Race was not associated with likelihood of wound complications in the final analysis.

Conclusions

We found that a subset of black patients with IBD continue to experience more adverse events compared to white patients, primarily driven by a higher need for postoperative blood transfusion. Nonetheless, known risk factors, including comorbid conditions, decreased BMI, open surgery, and emergency surgery have a stronger association with postoperative complications than race alone.

炎症性肠病患者的种族与术后结果的关系
背景以往的文献表明,炎症性肠病(IBD)手术后的术后并发症发生率因种族而异。目的本研究旨在探讨 IBD 患者的种族与不良事件和伤口并发症之间的关联。方法这是一项回顾性队列研究,研究对象是 2017 年至 2022 年期间的美国外科学院国家手术质量改进计划炎症性肠病协作组。数据收集自全美 15 个大容量 IBD 中心。采用粗略和多变量逻辑回归对数据进行了分析。结果研究纳入了4284名患者。不良事件和伤口并发症的总体发生率分别为20.3%和11.3%,双变量分析显示,不同种族的不良事件和伤口并发症发生率并无差异。白人、黑人和其他少数族裔受试者的不良事件发生率分别为 20.0% vs 24.6% vs 22.1%,p = 0.13。与白人受试者相比,黑人受试者发生不良事件的调整几率更高(1.46 [95%CI 1.0-2.1],p = 0.03)。其他少数民族受试者与黑人或白人受试者在不良事件方面没有差异(1.29 [0.7-2.3],p = 0.58)。在最终分析中,种族与伤口并发症的可能性无关。结论我们发现,与白人患者相比,部分黑人 IBD 患者仍会经历更多的不良事件,主要原因是术后输血的需求更高。尽管如此,已知的风险因素,包括合并症、体重指数下降、开放性手术和急诊手术与术后并发症的关系比单纯的种族因素更密切。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Digestive Diseases and Sciences
Digestive Diseases and Sciences 医学-胃肠肝病学
CiteScore
6.40
自引率
3.20%
发文量
420
审稿时长
1 months
期刊介绍: Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信