Racial disparities in surgical outcomes of patients with Inflammatory Bowel Disease

Montgomery, Samuel R.; Butler, Paris D.; Wirtalla, Chris; Collier, Karole T.; Hoffman, Rebecca L.; Aarons, Cary B.; Damrauer, Scott M.; Kelz, Rachel R.

doi:10.1016/j.amjsurg.2018.05.011

Cited by 40 publications

(18 citation statements)

References 32 publications

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“…Even after multivariable analysis, rates of extended HLOS were between 15% and 20% higher for African‐Americans and ‘Others’. These data are indirectly supported by previous studies such as that of Gunnells et al , who showed that African‐American patients with IBD have higher rates of 30‐day readmission after elective surgery, and Montgomery et al , who reported that African‐American patients with IBD undergoing surgery had significantly higher complication rates even after multivariable analysis.…”

Section: Discussionsupporting

confidence: 79%

Racial disparities after stoma construction in colorectal surgery

et al. 2020

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Aim Racial disparities are under‐recognized among patients undergoing colorectal surgery. The purpose of this study was to determine the complication rates and surgical outcomes stratified by race and ethnicity among patients undergoing colorectal surgery with intestinal stoma creation. Method The ACS NSQIP database from 2013 to 2016 was used. Colon, rectum and small bowel cases requiring intestinal stoma creation were selected. Both African‐American and other groups of minority patients were compared with Caucasian patients using a complex multivariable analysis model. Primary outcomes of interest were complication rates, mortality and extended hospital length of stay. Results The study included 38 088 admissions. After multivariable analysis, African‐American patients still had a prolonged length of hospital stay and higher complication rates. Other minorities also had a prolonged length of hospital stay and higher complication rates. Conclusions Both African‐American and other groups of minority patients requiring an ostomy suffer significantly higher postoperative complication rates and a prolonged hospital length of stay, even after comorbidity adjustment. Access to care, socioeconomic status and comorbid disease management are all important factors for minority patients who undergo colorectal surgery requiring intestinal stoma construction.

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Section: Discussionsupporting

confidence: 79%

Racial disparities after stoma construction in colorectal surgery

et al. 2020

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“…Similar findings were noted in another study wherein Black patients were noted to have 38% increased odds of major complication after IBD surgery compared with other racial and ethnic groups [32]. No racial differences in postoperative mortality were noted similar to what was seen in other studies [30,32,34].…”

Section: Disparities In Surgical Outcomessupporting

confidence: 86%

“…Another study found that Black, Hispanic and Asian IBD patients had a longer length of stay after IBD surgery compared with white IBD patients. In the study, Black patients had an increased likelihood of bleeding requiring transfusion, sepsis and renal insufficiency compared with white patients [34]. Similar findings were noted in another study wherein Black patients were noted to have 38% increased odds of major complication after IBD surgery compared with other racial and ethnic groups [32].…”

Section: Introductionsupporting

confidence: 79%

Inflammatory bowel disease in underserved populations: lessons for practice

Odufalu

Aboubakr

Anyane‐Yeboa

2022

Current Opinion in Gastroenterology

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Purpose of reviewThe incidence of inflammatory bowel disease (IBD) is increasing in minority groups across the USA. There are racial and ethnic disparities in IBD care and outcomes that are rooted in historical injustice and inequities in the social determinants of health.Recent findingsCurrent literature has identified racial, ethnic and sociodemographic disparities in therapeutics and outcomes for IBD, including disease severity, morbidity and mortality.SummaryStrategies to achieve equity in IBD include tackling structural racism as a driver of health disparities and making actionable changes against multilevel barriers to care.

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“…In a separate evaluation of data from National Surgical Quality Improvement Program, AA patients had an increased risk of death and serious morbidity after surgery for IBD, even after adjustments for potential confounders, such as age, sex, time to operation, smoking status, and obesity. 69 Enhanced recovery after surgery protocols have significantly reduced previously identified disparities between patients of different races. 70 Enhanced recovery after surgery protocols streamline the multidisciplinary management of patients with IBD before surgery, incorporating evidence-based practices focused on nutrition, prevention of postoperative ileus, and use of nonopioid analgesia and goal-directed fluid therapy (Table 2).…”

Section: Surgerymentioning

confidence: 99%

Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases

2021

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Although Crohn's disease (CD) and ulcerative colitis (UC) have been considered as disorders that affect individuals of European ancestry, the epidemiology of the inflammatory bowel diseases (IBDs) is changing. Coupled with the increasing incidence of IBD in previously low-incidence areas, the population demographics of IBD in the United States are also changing, with increases among non-White races and ethnicities. It is therefore important to fully understand the epidemiology and progression of IBD in different racial and ethnic groups, and the effects of race and ethnicity on access to care, use of resources, and disease-related outcomes. We review differences in IBD development and progression among patients of different races and ethnicities, discussing the effects of factors such as access to care, delays in diagnosis, and health and disease perception on disparities in IBD care and outcomes. We identify research priorities for improving health equity among minority patients with IBD.

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Racial disparities in surgical outcomes of patients with Inflammatory Bowel Disease

Abstract: Black patients are at increased risk of post-operative DSM following surgery for IBD. The elevated rates of DSM are not explained by traditional risk factors like obesity, ASA class, emergent surgery, or stoma creation.

Cited by 40 publications

References 32 publications

Racial disparities after stoma construction in colorectal surgery

Racial disparities after stoma construction in colorectal surgery

Inflammatory bowel disease in underserved populations: lessons for practice

Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases

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