Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease

Background: Racial disparities in surgical outcomes exist for Black patients with IBD compared to White patients. However, previous studies fail to include other racial/ethnic populations. We hypothesized these disparities exist for Hispanic and Asian patients. Methods: This is a retrospective cohort study of patients undergoing surgery for IBD using the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) database (2005 -2017). Bivariate comparisons and adjusted multivariable regressions were performed to evaluate associations between race and outcomes. Results: Of 23,901 patients with IBD, the racial/ethnic makeup were: 88.7% White, 7.6% Black, 2.4% Hispanic and 1.4% Asian. Overall mean LOS was 8 days (SD 8.2) and significantly varied between groups (8d for White, 10d for Black, 8.5d for Hispanic, and 11.1d for Asian; p < 0.001). Hispanic patients had the highest odds of readmission (OR: 1.4; 95% CI 1.1-1.8). Black patients had increased odds of renal insufficiency (OR: 1.8; 95% CI 1.1-2.9), bleeding requiring transfusions (OR: 1.7; 95% CI 1.4-1.9), and sepsis (OR: 1.7; 95% CI 1.4-2.02) compared to White patients. Conclusions: Racial disparities exist among IBD patients undergoing surgery. Black, Hispanic and Asian IBD patients experience major disparities in post-operative complications, readmissions and LOS, respectively, when compared to White patients with IBD. Future research is needed to better understand the mechanisms of these disparities including evaluation of social determinants of health. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

A retrospective cohort study using the ACS-NSQIP database revealed racial disparities in surgical outcomes for Black, Hispanic, and Asian patients with IBD compared to White patients. Black patients had increased odds of complications, Hispanic patients had higher odds of readmission, and Asian patients had longer hospital stays. Future research is needed to understand the mechanisms behind these disparities.