4.4 Article

Racial disparities in time to laparoscopic cholecystectomy for acute cholecystitis

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AMERICAN JOURNAL OF SURGERY
卷 226, 期 2, 页码 261-270

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EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2023.05.004

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Health equity; Surgery; Disparities; Implicit bias; Race

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This study compared the time from admission to laparoscopic cholecystectomy for acute cholecystitis between non-Hispanic Black and non-Hispanic White patients. The findings showed that a higher percentage of Black patients experienced a time to surgery longer than 1 day compared to White patients. In the multivariable analysis, Black patients were found to be more likely than White patients to experience a time to surgery longer than 1 day, even after controlling for potential confounding factors.
Background: Disparities in healthcare exist, yet few data are available on racial differences in time from admission to surgery. This study aimed to compare time from admission to laparoscopic cholecystectomy for acute cholecystitis between non-Hispanic Black and non-Hispanic White patients. Methods: Patients who underwent laparoscopic cholecystectomy for acute cholecystitis from 2010 to 2020 were identified using NSQIP. Time to surgery and additional preoperative, operative, and postoperative variables were analyzed. Results: In the univariate analysis, 19.4% of Black patients experienced a time to surgery >1 day compared with 13.4% of White patients (p < 0.0001). In the multivariable analysis, controlling for potential confounding factors, Black patients were found to be more likely than White patients to experience a time to surgery >1 day (OR 1.23, 95% CI 1.17-1.30, p < 0.0001). Conclusions: Further investigation is indicated to better define the nature and significance of gender, race, and other biases in surgical care. Surgeons should be aware that biases may adversely impact patient care and should strive to identify and proactively address them to promote health equity in surgery.

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