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Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status.

Publication ,  Journal Article
Haines, K; Rust, C; Nguyen, BP; Agarwal, S
Published in: The American surgeon
December 2018

Two main procedures are performed on patients suffering from colonic perforation, diverting colostomy and primary tissue repair. We investigated patient race, ethnicity, and socioeconomic status (SES) that predicted surgical outcomes after blunt or penetrating trauma. A retrospective analysis was performed using data from the National Trauma Data Bank for three years (2013-2015). We identified patients who presented with primary colonic injury and subsequent colon operation (n = 5431). Operations were grouped into three classes: colostomy, ileostomy, and nonostomy. Multiple linear and logistic regressions were performed to assess how race and insurance status are associated with the primary outcome of interest (ostomy formation) and secondary outcomes such as length of stay, time spent in ICU, and surgical site infection. Neither race/ethnicity nor insurance status proved to be reliable predictors for the formation of an ostomy. Patients who received either a colostomy or ileostomy were likely to have longer stays (OR [odds ratio]: 5.28; 95% CI [confidence interval]: 3.88-6.69) (OR: 11.24; 95% CI: 8.53-13.95), more time spent in ICU (2.73; 1.70-3.76) (7.98; 6.10-9.87), and increased risk for surgical site infection (1.32; 1.03-1.68) (2.54; 1.71-3.78). Race/ethnicity and SES were not reliable predictors for surgical decision-making on the formation of an ostomy after blunt and penetrating colonic injury. However, the severity of the injury as calculated by Injury Severity Score and the number of abdominal injuries were both associated with higher rates of colostomy and ileostomy. These data suggest that surgical decision-making is dependent on perioperative patient presentation and, not on race, ethnicity, or SES.

Duke Scholars

Published In

The American surgeon

EISSN

1555-9823

ISSN

0003-1348

Publication Date

December 2018

Volume

84

Issue

12

Start / End Page

1869 / 1875

Related Subject Headings

  • Young Adult
  • Wounds, Penetrating
  • Wounds, Nonpenetrating
  • United States
  • Surgery
  • Social Class
  • Racial Groups
  • Middle Aged
  • Male
  • Insurance Coverage
 

Citation

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Chicago
ICMJE
MLA
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Haines, K., Rust, C., Nguyen, B. P., & Agarwal, S. (2018). Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status. The American Surgeon, 84(12), 1869–1875.
Haines, Krista, Clayton Rust, Benjamin Pham Nguyen, and Suresh Agarwal. “Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status.The American Surgeon 84, no. 12 (December 2018): 1869–75.
Haines K, Rust C, Nguyen BP, Agarwal S. Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status. The American surgeon. 2018 Dec;84(12):1869–75.
Haines, Krista, et al. “Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status.The American Surgeon, vol. 84, no. 12, Dec. 2018, pp. 1869–75.
Haines K, Rust C, Nguyen BP, Agarwal S. Acute Surgical Decision-Making in Abdominal Trauma Is Not Altered by Race or Socioeconomic Status. The American surgeon. 2018 Dec;84(12):1869–1875.

Published In

The American surgeon

EISSN

1555-9823

ISSN

0003-1348

Publication Date

December 2018

Volume

84

Issue

12

Start / End Page

1869 / 1875

Related Subject Headings

  • Young Adult
  • Wounds, Penetrating
  • Wounds, Nonpenetrating
  • United States
  • Surgery
  • Social Class
  • Racial Groups
  • Middle Aged
  • Male
  • Insurance Coverage