Racial disparities after stoma construction in colorectal surgery

Sharp, Stephen P.; Ata, Ashar; Chismark, A David; Canete, Jonathan J.; Valerian, Brian T.; Wexner, S. D.; Lee, E. C.

doi:10.1111/codi.14943

Cited by 15 publications

(6 citation statements)

References 29 publications

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“…These findings have been previously reported in different settings and conditions [29,30]. Sharp et al demonstrated that African American patients undergoing the creation of an intestinal stoma had a higher complication rate and a longer LOS than Caucasian patients [31]. Further, Hecht et al suggested that race and socioeconomic status, such as low income, could predict who may suffer from poorer surgical outcomes [32].…”

Section: Discussionsupporting

confidence: 72%

Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay

et al. 2021

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Background This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility. Methods Rectal cancer patients who underwent elective surgery between January 2015 and December 2018 were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients. Results Of 2630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, advanced age, having open surgery, residence in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p < 0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p < 0.001). Conclusions Patients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Having permanent stoma was higher in patients living in South West Florida, patients with Medicaid insurance, and in the uninsured. Additionally, the payer type significantly affected the length of stay.

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Section: Discussionsupporting

confidence: 72%

Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay

et al. 2021

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“…These ndings have been previously reported in different settings and conditions (20,21). Sharp et al demonstrated that African American patients undergoing the creation of an intestinal stoma had a higher complication rate and a longer LOS than Caucasian patients (22). Further, Hecht et al suggested that race and socioeconomic status, such as low income, could predict who may suffer from poorer surgical outcomes (23).It is not entirely clear how such factors interact and, ultimately, how disparities occur.…”

Section: Discussionmentioning

confidence: 54%

Permanent Stoma: A Quality Outcome in Treatment of Rectal Cancer and Its Impact on Length of Stay

Lemini

Jabbal

Stanek

et al. 2021

Preprint

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Background This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility.MethodsRectal cancer patients were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic, and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients.ResultsOf 2,630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, residing in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p<0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p<0.001). ConclusionsPatients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Additionally, the payer type significantly affected the length of stay and odds of receiving a permanent stoma.

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“…Race was not a factor in affecting overall adjustment. Although no discussion was found in the literature that elaborated upon the relationship of race and PSA, Sharp and colleagues 23 found race and ethnicity to be related with higher complication rates and prolonged hospital stays in patients requiring ostomy surgery.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Psychosocial Adjustment in Persons With a Recent Ostomy

Doucette

Mawn

Beitz

et al. 2023

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: The aim of this study was to examine the influence of personal and clinical factors on psychosocial adjustment in persons living with an ostomy for less than 1 year. DESIGN: A cross-sectional survey. SUBJECTS AND SETTING: The study sample comprised 183 adult individuals who had a colostomy, ileostomy, or urostomy for less than 1 year, residing in the Northeastern United States. METHODS: Data were collected from May through November 2018 using 2 instruments: a sociodemographic questionnaire and the Ostomy Adjustment Inventory-23 (OAI-23). The OAI-23 items measured 4 psychosocial subscales: acceptance, anxious preoccupation, social engagement, and anger. Data were analyzed using analysis of variance, multivariate analysis of variance, Cramer's V correlations, and multiple regression. RESULTS: Univariate analysis indicated that factors influencing psychosocial adjustment to an ostomy include age, assistance with care, educational background, stomal type, body mass index, ostomy height, preoperative education, and stoma siting. Multivariate analysis of variance identified that those who reported independence with ostomy care experienced higher levels of adjustment in all areas of the OAI-23. CONCLUSIONS: Findings from this study may assist nurses and other care providers to better understand the physical and emotional needs of those with ostomies and to identify interventions to promote optimal health in this population.

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Racial disparities after stoma construction in colorectal surgery

Cited by 15 publications

References 29 publications

Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay

Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay

Permanent Stoma: A Quality Outcome in Treatment of Rectal Cancer and Its Impact on Length of Stay

Factors Affecting Psychosocial Adjustment in Persons With a Recent Ostomy

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