Differences in outcomes after emergency general surgery between Hispanic subgroups in the New Jersey State Inpatient Database (2009–2014): The Hispanic population is not monolithic - 12/08/21

Doi : 10.1016/j.amjsurg.2021.03.057

Lydia R. Maurer ^a,^{^{1
Co-first authors.}}, Sarah Rahman ^b,^{^{1
Co-first authors.}}, Numa Perez ^a,^c, Benjamin G. Allar ^d,^e, Emily Witt ^e,^f, Jackelyn Moya ^g, Margaret S. Pichardo ^h,ⁱ, Minerva Angelica Romero Arenas ^j, Tarsicio Uribe-Leitz ^e,^k, Tanujit Dey ^e, Regan W. Bergmark ^e,^l, Gregory Peck ^m,ⁿ, Gezzer Ortega ^e,^⁎
^a Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
^b Case Western Reserve University School of Medicine, Cleveland, OH, USA
^c Healthcare Transformation Lab, Massachusetts General Hospital, Boston, MA, USA
^d Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
^e Center for Surgery and Public Health, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
^f Harvard Medical School, Boston, MA, USA
^g David Geffen School of Medicine, Los Angeles, CA, USA
^h Howard University College of Medicine, Washington, DC, USA
ⁱ Yale School of Public Health, New Haven, CT, USA
^j Department of Surgery, New York Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medicine, New York, NY, USA
^k Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
^l Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
^m Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA
ⁿ Rutgers School of Public Health, Piscataway, NJ, USA

^∗Corresponding author. Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital/Harvard Medical School, One Brigham Circle, 1620 Tremont Street, Suite 2-016, Boston, MA, 02120, USA.Department of SurgeryCenter for Surgery and Public HealthBrigham and Women’s Hospital/Harvard Medical SchoolOne Brigham Circle1620 Tremont StreetSuite 2-016BostonMA02120USA

Abstract

Background

Our aim was to examine differences in clinical outcomes between Hispanic subgroups who underwent emergency general surgery (EGS).

Methods

Retrospective cohort study of the HCUP State Inpatient Database from New Jersey (2009–2014), including Hispanic and non-Hispanic White (NHW) adult patients who underwent EGS. Multivariable analyses were performed on outcomes including 7-day readmission and length of stay (LOS).

Results

125,874 patients underwent EGS operations. 22,971 were Hispanic (15,488 with subgroup defined: 7,331 - Central/South American; 4,254 - Puerto Rican; 3,170 - Mexican; 733 – Cuban). On multivariable analysis, patients in the Central/South American subgroup were more likely to be readmitted compared to the Mexican subgroup (OR 2.02; p < 0.001, respectively). Puerto Rican and Central/South American subgroups had significantly shorter LOS than Mexican patients (Puerto Rico −0.58 days; p < 0.001; Central/South American −0.30 days; p = 0.016).

Conclusions

There are significant differences in EGS outcomes between Hispanic subgroups. These differences could be missed when data are aggregated at Hispanic ethnicity.

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Highlights

•	Differences in surgical outcomes between Hispanic subgroups are under-investigated.
•	NJ State Inpatient Database used to study emergency general surgery (EGS) outcomes.
•	There are significant differences in EGS outcomes between Hispanic subgroups.
•	Hispanic ethnicity is not monolithic when it comes to EGS outcomes.
•	Aggregating Hispanic subgroups risks missing import inter-group differences.

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Keywords : Emergency general surgery, Health disparities, Health equity, Hispanic

Plan

Patient characteristics

Unadjusted surgical outcomes

Multivariable analyses

Sensitivity analyses excluding patients with readmission missing

Discussion

Conclusion

Funding

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Vol 222 - N° 3

P. 492-498 - septembre 2021 Retour au numéro

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Differences in outcomes after emergency general surgery between Hispanic subgroups in the New Jersey State Inpatient Database (2009–2014): The Hispanic population is not monolithic - 12/08/21

Abstract

Background

Methods

Results

Conclusions

Highlights

Plan

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