Evidence map›Paper›PMID 36976591›Full record

Observational studyThe western journal of emergency medicine2023

Assessing the Relationship Between Race, Language, and Surgical Admissions in the Emergency Department.

Grant H Rigney, Soham Ghoshal, Sarah Mercaldo, Debby Cheng, Jonathan J Parks, George C Velmahos, Michael H Lev, Ali S Raja, Efren J Flores, Marc D Succi

Open access · goldFull text readObservational Study
In one paragraph

Observational study in The western journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

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

10 authors at 2 institutions in 1 country.

Grant H RigneyHarvard Medical School, Boston, Massachusetts.
Soham GhoshalHarvard Medical School, Boston, Massachusetts.
Sarah MercaldoMassachusetts General Hospital, Department of Radiology, Boston, Massachusetts.
Debby ChengHarvard Medical School, Boston, Massachusetts.
Jonathan J ParksHarvard Medical School, Boston, Massachusetts.
George C VelmahosHarvard Medical School, Boston, Massachusetts.
Michael H LevMassachusetts General Hospital, Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Boston, Massachusetts.
Ali S RajaHarvard Medical School, Boston, Massachusetts.
Efren J FloresHarvard Medical School, Boston, Massachusetts.
Marc D SucciMassachusetts General Hospital, Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Boston, Massachusetts.
Massachusetts General Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEnglish proficiency and race are both independently known to affect surgical access and quality, but relatively little is known about the impact of race and limited English proficiency (LEP) on admission for emergency surgery from the emergency department (ED). Our objective was to examine the influence of race and English proficiency on admission for emergency surgery from the ED.

methodsWe conducted a retrospective observational cohort study from January 1-December 31, 2019 at a large, quaternary-care urban, academic medical center with a 66-bed ED Level I trauma and burn center. We included ED patients of all self-reported races reporting a preferred language other than English and requiring an interpreter or declaring English as their preferred language (control group). A multivariable logistic regression was fit to assess the association of LEP status, race, age, gender, method of arrival to the ED, insurance status, and the interaction between LEP status and race with admission for surgery from the ED.

resultsA total of 85,899 patients (48.1% female) were included in this analysis, of whom 3,179 (3.7%) were admitted for emergent surgery. Regardless of LEP status, patients identifying as Black (odds ratio [OR] 0.456, 95% CI 0.388-0.533; P<0.005), Asian [OR 0.759, 95% CI 0.612-0.929]; P=0.009), or female [OR 0.926, 95% CI 0.862-0.996]; P=0.04) had significantly lower odds for admission for surgery from the ED compared to White patients. Compared to individuals on Medicare, those with private insurance [OR 1.25, 95% CI 1.13-1.39; P <0.005) were significantly more likely to be admitted for emergent surgery, whereas those without insurance [OR 0.581, 95% CI 0.323-0.958; P=0.05) were significantly less likely to be admitted for emergent surgery. There was no significant difference in odds of admission for surgery between LEP vs non-LEP patients.

conclusionIndividuals without health insurance and those identifying as female, Black, or Asian had significantly lower odds of admission for surgery from the ED compared to those with health insurance, males, and those self-identifying as White, respectively. Future studies should assess the reasons underpinning this finding to elucidate impact on patient outcomes.

Indexed as

Communication BarriersMedicareAgedEmergency Service, HospitalFemaleHumansLanguageMaleRetrospective StudiesUnited States

Identifiers

PMID36976591
PMCPMC10047742
OpenAlexW4327815486

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read28
Read underepoch 390

Registered trials

None linked

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.