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07.01.2016 | Original Article | Ausgabe 5/2016

Journal of Gastrointestinal Surgery 5/2016

Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 5/2016
Autoren:
Drew J. Gunnells Jr., Melanie S. Morris, Aerin DeRussy, Allison A. Gullick, Talha A. Malik, Jamie A. Cannon, Mary T. Hawn, Daniel I. Chu
Wichtige Hinweise
This paper was presented in part as an E-Poster of Distinction on May 31, 2015 at the 2015 American Society of Colon and Rectal Surgery (ASCRS) Annual Meeting, Boston, MA
All authors contributed to the conception and design, data analysis/interpretation, and drafting/final approval of the publication.

Abstract

Background

The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery.

Design

The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression.

Results

Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 % were readmitted within 30 days of index operation. Black patients constituted 7.7 % of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 %) and Crohn’s diagnosis (84 vs. 73 %) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 %) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 % confidence interval 1.1–2.5).

Conclusions

Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.

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