所有种族的手术结果和社会人口差异:对 750 多万患者进行的 ACS-NSQIP 和 NHIS 多机构分析

Dany Y. Matar, S. Knoedler, Anthony Y. Matar, Sarah Friedrich, Harriet Kiwanuka, Ryoko Hamaguchi, C. Hamwi, G. Hundeshagen, V. Haug, Ulrich Kneser, Keisha Ray, Dennis P. Orgill, Adriana C. Panayi
{"title":"所有种族的手术结果和社会人口差异:对 750 多万患者进行的 ACS-NSQIP 和 NHIS 多机构分析","authors":"Dany Y. Matar, S. Knoedler, Anthony Y. Matar, Sarah Friedrich, Harriet Kiwanuka, Ryoko Hamaguchi, C. Hamwi, G. Hundeshagen, V. Haug, Ulrich Kneser, Keisha Ray, Dennis P. Orgill, Adriana C. Panayi","doi":"10.1097/as9.0000000000000467","DOIUrl":null,"url":null,"abstract":"\n \n This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics.\n \n \n \n In a registry-based cohort study using the 2008 to 2020 American College of Surgeons National Surgical Quality Improvement Program, we evaluated 24 postoperative outcomes through multivariable analysis, incorporating 28 preoperative risk factors. In a separate, independent analysis of the 2019 to 2020 National Health Interview Survey (NHIS) database, we examined sociodemographic racial/ethnic normative data.\n \n \n \n Among 7,504,734 American College of Surgeons National Surgical Improvement Database patients specifying race, 83.8% were White (WT), 11.8% Black or African American (B/AA), 3.3% Asian (AS), 0.7% American Indian or Alaska Native (AI/AN), 0.4% Native Hawaiian or Pacific Islander (NH/PI), 7.3% Hispanic. Reoperation trends reveal favorable outcomes for WT, AS, and NH/PI patients compared with B/AA and AI/AN patients. AI/AN patients exhibit higher rates of wound healing issues, while AS patients experience lower rates. AS and B/AA patients are more prone to transfusions, with B/AA patients showing elevated rates of pulmonary embolism, deep vein thrombosis, renal failure, and insufficiency. Disparities in discharge destinations exist. Hispanic patients fare better than non-WT Hispanic patients, contingent on race. Racial groups (excluding Hispanic patients) with superior surgical outcomes from the NSQIP analysis were found in the NHIS analysis to report higher wealth, better healthcare access, improved food security, greater functional and societal independence, and lower frailty.\n \n \n \n Our study underscores racial disparities in surgical outcomes. Focused investigations into these complications could reveal underlying causes, informing healthcare policies to enhance surgical care universally.\n","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients\",\"authors\":\"Dany Y. Matar, S. Knoedler, Anthony Y. Matar, Sarah Friedrich, Harriet Kiwanuka, Ryoko Hamaguchi, C. Hamwi, G. Hundeshagen, V. Haug, Ulrich Kneser, Keisha Ray, Dennis P. Orgill, Adriana C. Panayi\",\"doi\":\"10.1097/as9.0000000000000467\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics.\\n \\n \\n \\n In a registry-based cohort study using the 2008 to 2020 American College of Surgeons National Surgical Quality Improvement Program, we evaluated 24 postoperative outcomes through multivariable analysis, incorporating 28 preoperative risk factors. In a separate, independent analysis of the 2019 to 2020 National Health Interview Survey (NHIS) database, we examined sociodemographic racial/ethnic normative data.\\n \\n \\n \\n Among 7,504,734 American College of Surgeons National Surgical Improvement Database patients specifying race, 83.8% were White (WT), 11.8% Black or African American (B/AA), 3.3% Asian (AS), 0.7% American Indian or Alaska Native (AI/AN), 0.4% Native Hawaiian or Pacific Islander (NH/PI), 7.3% Hispanic. Reoperation trends reveal favorable outcomes for WT, AS, and NH/PI patients compared with B/AA and AI/AN patients. AI/AN patients exhibit higher rates of wound healing issues, while AS patients experience lower rates. AS and B/AA patients are more prone to transfusions, with B/AA patients showing elevated rates of pulmonary embolism, deep vein thrombosis, renal failure, and insufficiency. Disparities in discharge destinations exist. Hispanic patients fare better than non-WT Hispanic patients, contingent on race. Racial groups (excluding Hispanic patients) with superior surgical outcomes from the NSQIP analysis were found in the NHIS analysis to report higher wealth, better healthcare access, improved food security, greater functional and societal independence, and lower frailty.\\n \\n \\n \\n Our study underscores racial disparities in surgical outcomes. Focused investigations into these complications could reveal underlying causes, informing healthcare policies to enhance surgical care universally.\\n\",\"PeriodicalId\":503165,\"journal\":{\"name\":\"Annals of Surgery Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Surgery Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/as9.0000000000000467\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Surgery Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/as9.0000000000000467","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

本研究旨在通过检查不同种族/民族的术后结果,填补大规模登记评估的空白。重点是确定差异并将其与社会经济人口统计学进行比较。 在一项以登记为基础的队列研究中,我们使用了 2008 年至 2020 年美国外科学院国家外科质量改进计划,通过多变量分析评估了 24 种术后结果,并纳入了 28 种术前风险因素。在对 2019 年至 2020 年全国健康访谈调查 (NHIS) 数据库进行的单独、独立分析中,我们研究了社会人口种族/民族标准数据。 在7504734名美国外科学院国家外科改进数据库患者中,83.8%为白人(WT),11.8%为黑人或非裔美国人(B/AA),3.3%为亚裔(AS),0.7%为美洲印第安人或阿拉斯加原住民(AI/AN),0.4%为夏威夷原住民或太平洋岛民(NH/PI),7.3%为西班牙裔。与 B/AA 和 AI/AN 患者相比,WT、AS 和 NH/PI 患者的再手术趋势显示出良好的结果。亚裔美国人/印第安人患者的伤口愈合率较高,而 AS 患者的伤口愈合率较低。AS 和 B/AA 患者更容易输血,B/AA 患者的肺栓塞、深静脉血栓、肾衰竭和肾功能不全发生率更高。出院去向存在差异。西语裔患者的情况好于非输血的西语裔患者,这取决于种族。在 NHIS 分析中发现,NSQIP 分析中手术效果较好的种族群体(不包括西班牙裔患者)报告的财富较高、医疗保健服务较好、食品安全较好、功能和社会独立性较强、虚弱程度较低。 我们的研究强调了手术结果的种族差异。对这些并发症的重点调查可以揭示其根本原因,为医疗保健政策提供信息,从而普遍加强外科护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical Outcomes and Sociodemographic Disparities Across All Races: An ACS-NSQIP and NHIS Multi-Institutional Analysis of Over 7.5 Million Patients
This study aims to fill the gap in large-scale, registry-based assessments by examining postoperative outcomes across diverse races/ethnicities. The focus is on identifying disparities and comparing them with socioeconomic demographics. In a registry-based cohort study using the 2008 to 2020 American College of Surgeons National Surgical Quality Improvement Program, we evaluated 24 postoperative outcomes through multivariable analysis, incorporating 28 preoperative risk factors. In a separate, independent analysis of the 2019 to 2020 National Health Interview Survey (NHIS) database, we examined sociodemographic racial/ethnic normative data. Among 7,504,734 American College of Surgeons National Surgical Improvement Database patients specifying race, 83.8% were White (WT), 11.8% Black or African American (B/AA), 3.3% Asian (AS), 0.7% American Indian or Alaska Native (AI/AN), 0.4% Native Hawaiian or Pacific Islander (NH/PI), 7.3% Hispanic. Reoperation trends reveal favorable outcomes for WT, AS, and NH/PI patients compared with B/AA and AI/AN patients. AI/AN patients exhibit higher rates of wound healing issues, while AS patients experience lower rates. AS and B/AA patients are more prone to transfusions, with B/AA patients showing elevated rates of pulmonary embolism, deep vein thrombosis, renal failure, and insufficiency. Disparities in discharge destinations exist. Hispanic patients fare better than non-WT Hispanic patients, contingent on race. Racial groups (excluding Hispanic patients) with superior surgical outcomes from the NSQIP analysis were found in the NHIS analysis to report higher wealth, better healthcare access, improved food security, greater functional and societal independence, and lower frailty. Our study underscores racial disparities in surgical outcomes. Focused investigations into these complications could reveal underlying causes, informing healthcare policies to enhance surgical care universally.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
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