Skip to main content

11.09.2024 | Original Article

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

verfasst von: John J. Newland, Margaret H. Sundel, Kyle W. Blackburn, Roumen Vessilenov, Samuel Eisenstein, Andrea C. Bafford

Erschienen in: Digestive Diseases and Sciences

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥18 years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:1166–1169.CrossRefPubMed Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥18 years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:1166–1169.CrossRefPubMed
2.
Zurück zum Zitat Harbord M, Eliakim R, Bettenworth D, Karmiris K, Katsanos K, Kopylov U et al. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. J Crohns Colitis. 2017;11:769–84.CrossRefPubMed Harbord M, Eliakim R, Bettenworth D, Karmiris K, Katsanos K, Kopylov U et al. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. J Crohns Colitis. 2017;11:769–84.CrossRefPubMed
3.
Zurück zum Zitat Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK et al. British society of gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019;68:s1-106.CrossRefPubMed Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK et al. British society of gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019;68:s1-106.CrossRefPubMed
4.
5.
Zurück zum Zitat Barnes EL, Nowell WB, Venkatachalam S, Dobes A, Kappelman MD. Racial and ethnic distribution of inflammatory bowel disease in the United States. Inflamm Bowel Dis. 2022;28:983–987.CrossRefPubMed Barnes EL, Nowell WB, Venkatachalam S, Dobes A, Kappelman MD. Racial and ethnic distribution of inflammatory bowel disease in the United States. Inflamm Bowel Dis. 2022;28:983–987.CrossRefPubMed
6.
Zurück zum Zitat Veluswamy H, Suryawala K, Sheth A, Wells S, Salvatierra E, Cromer W et al. African-American inflammatory bowel disease in a Southern U.S. health center. BMC Gastroenterol. 2010;10:104.CrossRefPubMedPubMedCentral Veluswamy H, Suryawala K, Sheth A, Wells S, Salvatierra E, Cromer W et al. African-American inflammatory bowel disease in a Southern U.S. health center. BMC Gastroenterol. 2010;10:104.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Misra R, Faiz O, Munkholm P, Burisch J, Arebi N. Epidemiology of inflammatory bowel disease in racial and ethnic migrant groups. World J Gastroenterol. 2018;24:424–437.CrossRefPubMedPubMedCentral Misra R, Faiz O, Munkholm P, Burisch J, Arebi N. Epidemiology of inflammatory bowel disease in racial and ethnic migrant groups. World J Gastroenterol. 2018;24:424–437.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Mahid SS, Mulhall AM, Gholson RD, Eichenberger MR, Galandiuk S. Inflammatory bowel disease and African Americans: a systematic review. Inflamm Bowel Dis. 2008;14:960–967.CrossRefPubMed Mahid SS, Mulhall AM, Gholson RD, Eichenberger MR, Galandiuk S. Inflammatory bowel disease and African Americans: a systematic review. Inflamm Bowel Dis. 2008;14:960–967.CrossRefPubMed
9.
Zurück zum Zitat Aniwan S, Harmsen WS, Tremaine WJ, Loftus EV. Incidence of inflammatory bowel disease by race and ethnicity in a population-based inception cohort from 1970 through 2010. Ther Adv Gastroenterol. 2019;12:1756284819827692.CrossRef Aniwan S, Harmsen WS, Tremaine WJ, Loftus EV. Incidence of inflammatory bowel disease by race and ethnicity in a population-based inception cohort from 1970 through 2010. Ther Adv Gastroenterol. 2019;12:1756284819827692.CrossRef
10.
Zurück zum Zitat Peterson K, Anderson J, Boundy E, Ferguson L, McCleery E, Waldrip K. Mortality disparities in racial/ethnic minority groups in the veterans health administration: an evidence review and map. Am J Public Health. 2018;108:e1-11.CrossRefPubMedPubMedCentral Peterson K, Anderson J, Boundy E, Ferguson L, McCleery E, Waldrip K. Mortality disparities in racial/ethnic minority groups in the veterans health administration: an evidence review and map. Am J Public Health. 2018;108:e1-11.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Akinyemiju T, Meng Q, Vin-Raviv N. Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample. BMC Cancer 2016;16:715.CrossRefPubMedPubMedCentral Akinyemiju T, Meng Q, Vin-Raviv N. Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample. BMC Cancer 2016;16:715.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Dos Santos Marques IC, Theiss LM, Wood LN, Gunnells DJ, Hollis RH, Hardiman KM et al. Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease. Am J Surg. 2021;221:668–674.CrossRefPubMed Dos Santos Marques IC, Theiss LM, Wood LN, Gunnells DJ, Hollis RH, Hardiman KM et al. Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease. Am J Surg. 2021;221:668–674.CrossRefPubMed
13.
Zurück zum Zitat Gunnells DJ, Morris MS, DeRussy A, Gullick AA, Malik TA, Cannon JA et al. Racial Disparities in readmissions for patients with inflammatory bowel disease (IBD) after colorectal surgery. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2016;20:985–993.CrossRef Gunnells DJ, Morris MS, DeRussy A, Gullick AA, Malik TA, Cannon JA et al. Racial Disparities in readmissions for patients with inflammatory bowel disease (IBD) after colorectal surgery. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2016;20:985–993.CrossRef
14.
Zurück zum Zitat Montgomery SR, Butler PD, Wirtalla CJ, Collier KT, Hoffman RL, Aarons CB et al. Racial disparities in surgical outcomes of patients with inflammatory bowel disease. Am J Surg. 2018;215:1046–1050.CrossRefPubMed Montgomery SR, Butler PD, Wirtalla CJ, Collier KT, Hoffman RL, Aarons CB et al. Racial disparities in surgical outcomes of patients with inflammatory bowel disease. Am J Surg. 2018;215:1046–1050.CrossRefPubMed
15.
Zurück zum Zitat Holleran TJ, Napolitano MA, LaPiano JB, Arnott S, Amdur RL, Brody FJ et al. Racial disparities in 30-day outcomes after colorectal surgery in an integrated healthcare system. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2022;26:433–443.CrossRef Holleran TJ, Napolitano MA, LaPiano JB, Arnott S, Amdur RL, Brody FJ et al. Racial disparities in 30-day outcomes after colorectal surgery in an integrated healthcare system. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2022;26:433–443.CrossRef
16.
Zurück zum Zitat Esnaola NF, Hall BL, Hosokawa PW, Ayanian JZ, Henderson WG, Khuri SF et al. Race and surgical outcomes: it is not all black and white. Ann Surg. 2008;248:647–655.CrossRefPubMed Esnaola NF, Hall BL, Hosokawa PW, Ayanian JZ, Henderson WG, Khuri SF et al. Race and surgical outcomes: it is not all black and white. Ann Surg. 2008;248:647–655.CrossRefPubMed
17.
Zurück zum Zitat Khan IS, Huang E, Maeder-York W, Yen RW, Simmons NE, Ball PA et al. Racial disparities in outcomes after spine surgery: a systematic review and meta-analysis. World Neurosurg. 2022;157:e232–e244.CrossRefPubMed Khan IS, Huang E, Maeder-York W, Yen RW, Simmons NE, Ball PA et al. Racial disparities in outcomes after spine surgery: a systematic review and meta-analysis. World Neurosurg. 2022;157:e232–e244.CrossRefPubMed
18.
Zurück zum Zitat Causey MW, McVay D, Hatch Q, Johnson E, Maykel JA, Champagne B et al. The impact of race on outcomes following emergency surgery: an American college of surgeons national surgical quality improvement program assessment. Am J Surg. 2013;206:172–179.CrossRefPubMed Causey MW, McVay D, Hatch Q, Johnson E, Maykel JA, Champagne B et al. The impact of race on outcomes following emergency surgery: an American college of surgeons national surgical quality improvement program assessment. Am J Surg. 2013;206:172–179.CrossRefPubMed
19.
Zurück zum Zitat Best MJ, McFarland EG, Thakkar SC, Srikumaran U. Racial disparities in the use of surgical procedures in the US. JAMA Surg. 2021;156:274–281.CrossRefPubMed Best MJ, McFarland EG, Thakkar SC, Srikumaran U. Racial disparities in the use of surgical procedures in the US. JAMA Surg. 2021;156:274–281.CrossRefPubMed
20.
Zurück zum Zitat Sewell JL, Velayos FS. Systematic review: The role of race and socioeconomic factors on IBD healthcare delivery and effectiveness. Inflamm Bowel Dis. 2013;19:627–643.CrossRefPubMed Sewell JL, Velayos FS. Systematic review: The role of race and socioeconomic factors on IBD healthcare delivery and effectiveness. Inflamm Bowel Dis. 2013;19:627–643.CrossRefPubMed
22.
Zurück zum Zitat Eisenstein S, Stringfield S, Holubar SD. Using the national surgical quality improvement project (NSQIP) to perform clinical research in colon and rectal surgery. Clin Colon Rectal Surg. 2019;32:41–53.CrossRefPubMedPubMedCentral Eisenstein S, Stringfield S, Holubar SD. Using the national surgical quality improvement project (NSQIP) to perform clinical research in colon and rectal surgery. Clin Colon Rectal Surg. 2019;32:41–53.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Eisenstein S, Holubar SD, Hilbert N, Bordeianou L, Crawford LA, Hall B et al. The ACS national surgical quality improvement program - inflammatory bowel disease collaborative: design, implementation, and validation of a disease-specific module. Inflamm Bowel Dis. 2019;25:1731–1739.CrossRefPubMed Eisenstein S, Holubar SD, Hilbert N, Bordeianou L, Crawford LA, Hall B et al. The ACS national surgical quality improvement program - inflammatory bowel disease collaborative: design, implementation, and validation of a disease-specific module. Inflamm Bowel Dis. 2019;25:1731–1739.CrossRefPubMed
24.
Zurück zum Zitat Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A et al. Racism as a determinant of health: a systematic review and meta-analysis. PLoS ONE. 2015;10:e0138511.CrossRefPubMedPubMedCentral Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A et al. Racism as a determinant of health: a systematic review and meta-analysis. PLoS ONE. 2015;10:e0138511.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Manuel JI. Racial/ethnic and gender disparities in health care use and access. Health Serv Res. 2018;53:1407–1429.CrossRefPubMed Manuel JI. Racial/ethnic and gender disparities in health care use and access. Health Serv Res. 2018;53:1407–1429.CrossRefPubMed
27.
Zurück zum Zitat Hill SS, Ottaviano KE, Palange DC, Chismark AD, Valerian BT, Canete JJ et al. Impact of preoperative factors in patients with IBD on postoperative length of stay: A national surgical quality improvement program-inflammatory bowel disease collaborative analysis. Dis Colon Rectum. 2024;67:97–106.PubMed Hill SS, Ottaviano KE, Palange DC, Chismark AD, Valerian BT, Canete JJ et al. Impact of preoperative factors in patients with IBD on postoperative length of stay: A national surgical quality improvement program-inflammatory bowel disease collaborative analysis. Dis Colon Rectum. 2024;67:97–106.PubMed
28.
Zurück zum Zitat Guasch M, Vela E, Mañosa M, Clèries M, Cañete F, Parés D et al. Postoperative mortality after surgery for inflammatory bowel disease in the era of biological agents: a population-based study in Southern Europe. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2021;53:54–60. Guasch M, Vela E, Mañosa M, Clèries M, Cañete F, Parés D et al. Postoperative mortality after surgery for inflammatory bowel disease in the era of biological agents: a population-based study in Southern Europe. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2021;53:54–60.
29.
Zurück zum Zitat Jiang K, Chen B, Lou D, Zhang M, Shi Y, Dai W et al. Systematic review and meta-analysis: association between obesity/overweight and surgical complications in IBD. Int J Colorectal Dis. 2022;37:1485–1496.CrossRefPubMedPubMedCentral Jiang K, Chen B, Lou D, Zhang M, Shi Y, Dai W et al. Systematic review and meta-analysis: association between obesity/overweight and surgical complications in IBD. Int J Colorectal Dis. 2022;37:1485–1496.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Sampietro GM, Colombo F, Corsi F. Sequential approach for a critical-view COlectomy (SACCO): a laparoscopic technique to reduce operative time and complications in IBD acute severe colitis. J Clin Med. 2020;9:3382.CrossRefPubMedPubMedCentral Sampietro GM, Colombo F, Corsi F. Sequential approach for a critical-view COlectomy (SACCO): a laparoscopic technique to reduce operative time and complications in IBD acute severe colitis. J Clin Med. 2020;9:3382.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Sakurai Kimura CM, Scanavini Neto A, Queiroz NSF, Horvat N, Camargo MGM, Borba MR et al. Abdominal surgery in crohn’s disease: risk factors for complications. Inflamm Intest Dis. 2021;6:18–24.CrossRefPubMed Sakurai Kimura CM, Scanavini Neto A, Queiroz NSF, Horvat N, Camargo MGM, Borba MR et al. Abdominal surgery in crohn’s disease: risk factors for complications. Inflamm Intest Dis. 2021;6:18–24.CrossRefPubMed
32.
Zurück zum Zitat Arsoniadis EG, Ho Y-Y, Melton GB, Madoff RD, Le C, Kwaan MR. African Americans and short-term outcomes after surgery for crohn’s disease: an ACS-NSQIP analysis. J Crohns Colitis. 2017;11:468–473.PubMed Arsoniadis EG, Ho Y-Y, Melton GB, Madoff RD, Le C, Kwaan MR. African Americans and short-term outcomes after surgery for crohn’s disease: an ACS-NSQIP analysis. J Crohns Colitis. 2017;11:468–473.PubMed
33.
Zurück zum Zitat Ore AS, Vigna C, Fabrizio A, Messaris E. Evaluation of racial/ethnic disparities in the surgical management of inflammatory bowel disease. J Gastrointest Surg. 2022;26:2559–2568.CrossRefPubMed Ore AS, Vigna C, Fabrizio A, Messaris E. Evaluation of racial/ethnic disparities in the surgical management of inflammatory bowel disease. J Gastrointest Surg. 2022;26:2559–2568.CrossRefPubMed
34.
Zurück zum Zitat Lau C, Dubinsky M, Melmed G, Vasiliauskas E, Berel D, McGovern D et al. The Impact of preoperative serum anti-TNFα therapy levels on early postoperative outcomes in inflammatory bowel disease surgery. Ann Surg. 2015;261:487–496.CrossRefPubMed Lau C, Dubinsky M, Melmed G, Vasiliauskas E, Berel D, McGovern D et al. The Impact of preoperative serum anti-TNFα therapy levels on early postoperative outcomes in inflammatory bowel disease surgery. Ann Surg. 2015;261:487–496.CrossRefPubMed
35.
Zurück zum Zitat Law CC, Bell C, Koh D, Bao Y, Jairath V, Narula N. Risk of postoperative infectious complications from medical therapies in inflammatory bowel disease. Cochrane Database Syst Rev. 2020;2020:CD013256.PubMedCentral Law CC, Bell C, Koh D, Bao Y, Jairath V, Narula N. Risk of postoperative infectious complications from medical therapies in inflammatory bowel disease. Cochrane Database Syst Rev. 2020;2020:CD013256.PubMedCentral
36.
Zurück zum Zitat Yu CS, Jung SW, Lee JL, Lim S-B, Park IJ, Yoon YS et al. The influence of preoperative medications on postoperative complications in patients after intestinal surgery for Crohn’s disease. Inflamm Bowel Dis. 2019;25:1559–1568.CrossRefPubMed Yu CS, Jung SW, Lee JL, Lim S-B, Park IJ, Yoon YS et al. The influence of preoperative medications on postoperative complications in patients after intestinal surgery for Crohn’s disease. Inflamm Bowel Dis. 2019;25:1559–1568.CrossRefPubMed
37.
Zurück zum Zitat Visser A, Geboers B, Gouma DJ, Goslings JC, Ubbink DT. Predictors of surgical complications: a systematic review. Surgery. 2015;158:58–65.CrossRefPubMed Visser A, Geboers B, Gouma DJ, Goslings JC, Ubbink DT. Predictors of surgical complications: a systematic review. Surgery. 2015;158:58–65.CrossRefPubMed
38.
Zurück zum Zitat Yu H, MacIsaac D, Wong JJ, Sellers ZM, Wren AA, Bensen R et al. Market share and costs of biologic therapies for inflammatory bowel disease in the United States. Aliment Pharmacol Ther. 2018;47:364–370.CrossRefPubMed Yu H, MacIsaac D, Wong JJ, Sellers ZM, Wren AA, Bensen R et al. Market share and costs of biologic therapies for inflammatory bowel disease in the United States. Aliment Pharmacol Ther. 2018;47:364–370.CrossRefPubMed
39.
Zurück zum Zitat Park KT, Ehrlich OG, Allen JI, Meadows P, Szigethy EM, Henrichsen K et al. The cost of inflammatory bowel disease: an initiative from the Crohn’s & colitis foundation. Inflamm Bowel Dis. 2020;26:1–10.CrossRefPubMed Park KT, Ehrlich OG, Allen JI, Meadows P, Szigethy EM, Henrichsen K et al. The cost of inflammatory bowel disease: an initiative from the Crohn’s & colitis foundation. Inflamm Bowel Dis. 2020;26:1–10.CrossRefPubMed
Metadaten
Titel
Association of Race and Postoperative Outcomes in Patients with Inflammatory Bowel Disease
verfasst von
John J. Newland
Margaret H. Sundel
Kyle W. Blackburn
Roumen Vessilenov
Samuel Eisenstein
Andrea C. Bafford
Publikationsdatum
11.09.2024
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-024-08594-4

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Innere Medizin

Studie zur HIFU bei Prostatakrebs lässt viele Fragen offen

Führt eine HIFU-Ablation beim Prostatakarzinom im Vergleich mit einer radikalen Prostatektomie zu ähnlichen onkologischen, aber besseren funktionalen Ergebnissen? Interimsdaten der französischen HIFI-Studie sind uneindeutig. In einem Kommentar zur Studie werden zumindest drei allgemeine Erkenntnisse herausgearbeitet.

Leitlinienkonformes Management thermischer Verletzungen

Thermische Verletzungen gehören zu den schwerwiegendsten Traumen und hinterlassen oft langfristige körperliche und psychische Spuren. Die aktuelle S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter (Verbrennung, Verbrühung)“ bietet eine strukturierte Übersicht über das empfohlene Vorgehen.

Verschlechtert frühe Hyperoxie nach Reanimation die Prognose?

Kommt es sehr früh nach einer kardiopulmonalen Reanimation zu einem Zustand der Hyperoxie, ist dies bei Patienten nach einem Herzstillstand mit schlechteren funktionellen Ergebnissen assoziiert. Das zeigt eine Sekundäranalyse der TTM-2-Studie.

Infektanfälligkeit in früher Kindheit: eine bleibende Last?

Wenn Kinder in den ersten Lebensjahren immer wieder Infekte durchmachen, lässt dies Schlüsse auf die Infektneigung in der weiteren Kindheit zu.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.