Evidence map›Paper›PMID 34581979›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022

Racial Disparities in 30-Day Outcomes After Colorectal Surgery in an Integrated Healthcare System.

Timothy J Holleran, Michael A Napolitano, Jessica B LaPiano, Suzanne Arnott, Richard L Amdur, Fredrick J Brody, James E Duncan

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Timothy J HolleranDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
Michael A NapolitanoDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
Jessica B LaPianoDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
Suzanne ArnottDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
Richard L AmdurDepartment of Surgery, George Washington University Hospital, Washington, DC, USA.
Fredrick J BrodyDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
James E DuncanDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA. James.duncan1@va.gov.ORCID 0000-0001-6249-7727

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRacial disparities in colorectal surgery outcomes have been studied extensively in the USA, and access to healthcare resources may contribute to these differences. The Veterans Health Administration (VHA) is the largest integrated healthcare network in the USA with the potential for equal access care to veterans. The objective of this study is to evaluate the VHA for the presence of racial disparities in 30-day outcomes of patients that underwent colorectal resection.

methodsColon and rectal resections from 2008 to 2019 were reviewed retrospectively using the Veterans Affairs Surgical Quality Improvement Program database. Patients were categorized by race and ethnicity. Multivariable analysis was used to compare 30-day outcomes. Cases with "unknown/other/declined to answer" race/ethnicity were excluded.

resultsThirty-six-thousand-nine-hundred-sixty-nine cases met inclusion criteria: 27,907 (75.5%) Caucasian, 6718 (18.2%) African American, 2047 (5.5%) Hispanic, and 290 (0.8%) Native American patients. There were no statistically significant differences in overall complication incidence or mortality between all cohorts. Compared to Caucasian race, African American patients had longer mean length of stay (10.7 days vs. 9.7 days; p < 0.001). Compared to Caucasian race, Hispanic patients had higher odds of pulmonary-specific complications (adjusted odds ratio with 95% confidence interval = 1.39 [1.17-1.64]; p < 0.001).

conclusionsThe VHA provides the benefits of integrated healthcare and access, which may explain the improvements in racial disparities compared to existing literature. However, some racial disparities in clinical outcomes still persisted in this analysis. Further efforts beyond healthcare access are needed to mitigate disparities in colorectal surgery. CLASSIFICATIONS: [Outcomes]; [Database]; [Veterans]; [Colorectal Surgery]; [Morbidity]; [Mortality].

Indexed as

Colorectal SurgeryDelivery of Health Care, IntegratedHealthcare DisparitiesHumansRetrospective StudiesUnited StatesWhite PeopleColorectal/IBDHealth systems and health services research

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.