Format

Send to

Choose Destination
Gynecol Oncol. 2014 Sep;134(3):510-5. doi: 10.1016/j.ygyno.2014.05.024. Epub 2014 Jun 3.

Racial disparity in the 30-day morbidity and mortality after surgery for endometrial cancer.

Author information

1
Gynecologic Oncology division, Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: mahdih6281@gmail.com.
2
Department of Biostatistics, University of Washington, Seattle, WA, USA.
3
Gynecologic Oncology division, Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.

Abstract

OBJECTIVES:

To examine postoperative 30-day morbidity and mortality in African American (AA) compared to white patients (W) with endometrial cancer (EC).

METHODS:

Patients with EC were identified from the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2011. AA and W subgroups were studied. Multivariable logistic regression models were performed.

RESULTS:

Of 3248 patients, 2899 (89%) W and 349 (11%) AA were identified. AA were more likely to have diabetes, hypertension, ascites, neurologic morbidities, weight loss, non-independent functional status, higher ASA class, higher serum creatinine ≥ 2 mg/dl, hypoalbuminemia and anemia. Laparoscopic surgery was performed less frequently in AA than W (41.4% vs. 50.3%, p<0.001). AA had a significantly higher risk of postoperative complications than W (21% vs. 12%, p<0.001) including surgical (17% vs. 10%, p<0.001) and non-surgical complications (7% vs. 4%, p=0.022). Mean length of hospital stay and operative time were longer in AA than W but there was no difference in surgical re-exploration. In multivariable model after adjustment for confounders including surgical complexity and associated morbidities, AA race was not an independent predictor of "any postoperative complications" for both laparotomy group (OR 1.1, 95% CI 0.73-1.61, p=0.65) and laparoscopic group (OR 1.43, 95% CI 0.80-2.45, p=0.21). No difference in 30-day mortality was found between AA and W (1% vs. 1%, p=0.11).

CONCLUSIONS:

AA patients with EC have more preoperative morbidities, postoperative complications and were less likely to undergo minimally invasive surgery. However, AA race was not an independent predictor of poor 30-day outcomes after controlling for other confounders.

KEYWORDS:

African American; Endometrial cancer; Morbidity and Mortality; Race; Surgery; White

PMID:
24905775
DOI:
10.1016/j.ygyno.2014.05.024
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center