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Racial Disparities in the Incidence of Pulmonary Embolism after Colectomy. | LitMetric

Racial Disparities in the Incidence of Pulmonary Embolism after Colectomy.

Am Surg

Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA.

Published: October 2018

AI Article Synopsis

  • - The study analyzed the incidence of pulmonary embolism (PE) among adult patients who had colectomy between 2005 and 2014, focusing on the influence of race and hospital characteristics, especially contrasting high-burden hospitals (HBHs) and low-burden hospitals.
  • - Results showed that Black patients had a significantly higher rate of PE compared to White and Hispanic patients, with rates increasing over the study period from 0.6% in 2005 to 0.95% in 2014.
  • - The research concluded that both receiving colectomy at HBHs and being Black were independent predictors of higher PE rates, highlighting a need for targeted interventions to improve surgical care and outcomes for vulnerable populations.

Article Abstract

Disparities in the incidence of pulmonary embolism (PE) based on racial and socioeconomic factors remain ill-defined. The present study evaluated the impact of race and hospital characteristics on rates of PE for all adult colectomy patients in the 2005 to 2014 Nationwide Inpatient Sample. Hospitals were designated as high-burden hospitals (HBHs) or low-burden hospitals of underinsured payers. Chi-squared tests of trend and multivariable regression adjusting for patient and hospital characteristics were performed. Of the 2,737,977 adult patients who underwent colectomy in the study period, 79 per cent were White, 10 per cent Black, and 7 per cent Hispanic. The annual rate of PE increased from 0.6 per cent in 2005 to 0.95 per cent in 2014 ( < 0.0001). Black patients had significantly higher incidence of PE than Whites (1.5% 0.9%, < 0.001) and Hispanics (1.5% 0.8%, < 0.001). Colectomy at HBHs was also associated with significantly higher rates of PE (1% 0.86%, < 0.001). After adjusting for baseline differences, colectomy at HBHs (odds ratio 1.14, 95% confidence interval 1.02-1.27, = 0.02) and Black race (odds ratio 1.4, 95% confidence interval 1.26-1.66, < 0.001) were independent predictors of PE. In this national study of colectomy patients, Black patients experienced a disproportionate burden of postoperative PE. Further investigation into the causes and prevention of PE in vulnerable populations may identify targets for surgical quality improvement.

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