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Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample.

Publication ,  Journal Article
Akinyemiju, T; Meng, Q; Vin-Raviv, N
Published in: BMC Cancer
September 5, 2016

BACKGROUND: The purpose of this study was to examine racial and socio-economic differences in the receipt of laparoscopic or open surgery among patients with colorectal cancer, and to determine if racial and socio-economic differences exist in post-surgical complications, in-hospital mortality and hospital length of stay among patients who received surgery. METHODS: We conducted a cross-sectional analysis of hospitalized patients with a primary diagnosis of colorectal cancer between 2007 and 2011 using data from Nationwide Inpatient Sample. ICD-9 codes were used to capture primary diagnosis, surgical procedures, and health outcomes during hospitalization. We used logistic regression analysis to determine racial and socio-economic predictors of surgery type, post-surgical complications and mortality, and linear regression analysis to assess hospital length of stay. RESULTS: A total of 122,631 patients were admitted with a primary diagnosis of malignant colorectal cancer between 2007 and 2011. Of these, 17,327 (14.13 %) had laparoscopic surgery, 70,328 (57.35 %) received open surgery, while 34976 (28.52 %) did not receive any surgery. Black (36 %) and Hispanic (34 %) patients were more likely to receive no surgery compared with Whites (27 %) patients. However, among patients that received any surgery, there were no racial differences in which surgery was received (laparoscopic versus open, p = 0.2122), although socio-economic differences remained, with patients from lower residential income areas significantly less likely to receive laparoscopic surgery compared with patients from higher residential income areas (OR: 0.74, 95 % CI: 0.70-0.78). Among patients who received any surgery, Black patients (OR = 1.07, 95 % CI: 1.01-1.13), and patients with Medicare (OR = 1.16, 95 % CI: 1.11-1.22) and Medicaid (OR = 1.15, 95 % CI: 1.07-1.25) insurance experienced significantly higher post-surgical complications, in-hospital mortality (Black OR = 1.18, 95 % CI: 1.00-1.39), and longer hospital stay (Black β = 1.33, 95 % CI: 1.16-1.50) compared with White patients or patients with private insurance. CONCLUSION: Racial and socio-economic differences were observed in the receipt of surgery and surgical outcomes among hospitalized patients with malignant colorectal cancer in the US.

Duke Scholars

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Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

September 5, 2016

Volume

16

Issue

1

Start / End Page

715

Location

England

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Racial Groups
  • Postoperative Complications
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Length of Stay
  • Laparoscopy
  • Inpatients
 

Citation

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ICMJE
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Akinyemiju, T., Meng, Q., & Vin-Raviv, N. (2016). Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample. BMC Cancer, 16(1), 715. https://doi.org/10.1186/s12885-016-2738-7
Akinyemiju, Tomi, Qingrui Meng, and Neomi Vin-Raviv. “Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample.BMC Cancer 16, no. 1 (September 5, 2016): 715. https://doi.org/10.1186/s12885-016-2738-7.
Akinyemiju, Tomi, et al. “Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample.BMC Cancer, vol. 16, no. 1, Sept. 2016, p. 715. Pubmed, doi:10.1186/s12885-016-2738-7.
Journal cover image

Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

September 5, 2016

Volume

16

Issue

1

Start / End Page

715

Location

England

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Racial Groups
  • Postoperative Complications
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Length of Stay
  • Laparoscopy
  • Inpatients