Racial Disparities in Tympanoplasty Surgery: A 30-Day Morbidity and Mortality National Cohort Study

Abstract

Objectives: To assess the impact of race and ethnicity on 30-day complications after tympanoplasty surgery. Methods: The National Surgical Quality Improvement Program database was queried for tympanoplasty procedures from 2005 to 2019. Demographic, comorbidity, and postoperative complication data were compared according to race using univariate and binary logistic regression analyses. Results: A total of 11,701 patients were included, consisting of 80.3% White, 3.0% Black, 7.7% Asian, 5.7% Hispanic, 2.5% American Indian/Alaska Native, and 0.8% other. Binary logistic regression model indicated that Black patients had increased odds of unplanned readmittance ( p = 0.033; odds ratio [OR], 3.110) and deep surgical site infections ( p = 0.008; OR, 6.292). American Indian/Alaska Native patients had increased odds of reoperation ( p = 0.022; OR, 6.343), superficial surgical site infections ( p < 0.001; OR, 5.503), urinary tract infections ( p < 0.001; OR, 18.559), surgical complications ( p < 0.001; OR, 3.820), medical complications ( p = 0.001; OR, 10.126), and overall complications ( p < 0.001; OR, 4.545). Conclusion: Although Black and American Indian/Alaskan Native patients were more likely to have complications after tympanoplasty surgery after adjusting for comorbidities, age, and sex, these results are tempered by an overall low rate of complications. Future studies should be devoted to understanding the drivers of these health inequities in access to otologic care and surgical treatment to improve outcomes and achieve equitable care.