Racial disparities in length-of-stay persist even with no postoperative complications

• Published in: The Journal of surgical research Vol. 214; pp. 14 - 22
• Main Authors: Giglia, Matthew D., MD, DeRussy, Aerin, MPH, Morris, Melanie S., MD, Richman, Joshua S., MD, PhD, Hawn, Mary T., MD, Vickers, Selwyn M., MD, Knight, Sara J., PhD, Chu, Daniel I., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.06.2017
• Subjects: Adult; Aged, 80 and over; Colectomy; Colorectal surgery; Databases, Factual; Female; Health Status Disparities; Healthcare Disparities - ethnology; Healthcare disparity; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Postoperative Complications - ethnology; Racial disparity; Surgery; United States; Racial disparity; Colorectal surgery; Healthcare disparity
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2017.02.063

Abstract Purpose To determine the contribution of race to postoperative length-of-stay in elective colorectal surgery without complications. Methods The 2012-2013 National Surgical Quality Improvement Program Colectomy-Targeted Database was queried for patients undergoing elective colorectal surgery without complications. After stratifying by race, univariate/bivariate comparisons were made. On adjusted comparison, predictors of postoperative length-of-stay were identified along with incident rate ratios and Least Squares Means for predicted length-of-stays. Results Of 28,480 elective colorectal surgeries, 19,898 patients had no postoperative complications. Patients stratified to white (84%), black (8%), Hispanic (3%), and Asian (3%). Overall mean postoperative length-of-stay was 4.8 d, with black patients having longest at 5.3 d ( P  < 0.05). After covariate adjustment, black race increased postoperative length-of-stay by 9%, 7%, and 6% compared to white, Hispanic, and Asian patients, respectively ( P  < 0.05). No statistical difference existed in postoperative length-of-stay for Hispanic and Asian patients versus white patients. Adjusted postoperative length-of-stay was 5.1 d for black patients compared to 4.7, 4.8, and 4.8 d for white, Hispanic, and Asian patients, respectively ( P  < 0.05). Conclusions Black patients have significantly longer postoperative length-of-stay after elective colorectal surgery even if no postoperative complications occur. Further studies are needed to understand the mechanism(s) for these disparities.