Racial disparities in postoperative outcomes persist for patients with inflammatory bowel disease under a colorectal enhanced recovery program - 29/08/23
Abstract |
Introduction |
Enhanced recovery programs (ERPs) reduce racial disparities in surgical outcomes for general colorectal surgery populations. It is unclear, however, if disparities in IBD populations are impacted by ERPs.
Methods |
Retrospective study comparing IBD patients undergoing major elective colorectal operations before (2006–2014) and after (2015–2021) ERP implementation using ACS-NSQIP data. The primary outcome of length of stay (LOS) was analyzed by negative binomial regression, and secondary outcomes (complications and readmissions) by logistic regression.
Results |
Of 466 IBD patients, 47% were pre-ERP and 53% were ERP patients. In multivariable analysis stratified by ERP period, Black race was associated with increased odds of complications in the pre-ERP (OR 3.6, 95%CI 1.4–9.3) and ERP groups (OR 3.1 95%CI 1.3–7.6). Race was not a predictor of LOS or readmission in either group. High social vulnerability was associated with increased odds of readmission pre-ERP (OR 15.1, 95%CI 2.1–136.3), but this disparity was mitigated under ERPs (OR 1.4, 95%CI 0.4–5.6).
Conclusion |
While ERPs mitigated some disparities by social vulnerability, racial disparities persist in IBD populations even under ERPs. Further work is needed to achieve surgical equity for IBD patients.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Racial disparities in surgical outcomes of IBD patients undergoing surgery exist. |
• | Enhanced recovery implementation may not improve racial disparities in complications. |
• | Enhanced recovery may improve disparities in readmission rates previously seen among socially vulnerable IBD patients. |
Keywords : Inflammatory bowel disease, Enhanced recovery, Surgical disparities
Plan
Vol 226 - N° 2
P. 227-232 - août 2023 Retour au numéro
Article précédent
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