Racial/Ethnic Differences in the Risk of Surgical Complications and Posthysterectomy Hospitalization among Women Undergoing Hysterectomy for Benign Conditions

Pollack, Lisa M.; Lowder, Jerry L.; Keller, Matthew; Chang, Samuel F.; Gehlert, Sarah; Olsen, Margaret A.

doi:10.1016/j.jmig.2020.12.032

Cited by 14 publications

(16 citation statements)

References 43 publications

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“…Multivariable analysis confirmed such racial risk correlation, with statistically significant associations between Asian OS patients and the need for readmission and blood transfusion ( Table 8 ). Notably, when analyzing the occurrence of surgical complications among different races, Pollack et al also found Asian patients to be at higher risk of hemorrhage [ 53 ]. Misumida et al reiterated the disproportionate risk of bleeding in Asian patients, reporting a significant correlation between Asian ethnicity and the occurrence of major in-hospital bleeding [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Knoedler

Baecher

Hoch

et al. 2023

JCM

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Background: Orthognathic surgery (OS) is a frequently performed procedure for the correction of dentofacial deformities and malocclusion. Research on OS is mostly limited to single-surgeon experience or single-institutional reports. We, therefore, retrospectively analyzed a multi-institutional database to investigate outcomes of OS and identify risk factors for peri- and postoperative complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008–2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications. Results: The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009). Conclusion: Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.

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Section: Discussionmentioning

confidence: 99%

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Knoedler

Baecher

Hoch

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Hispanic heritage was similarly associated with 30-day hospitalizations, while patients of Asian/Pacific Islander descent had increased rates of urological injury. 24 Countless studies have confirmed a higher risk of complications among non-White women after hysterectomy. 3,19,21,24,25 We must acknowledge that patients' preexisting conditions impact surgical outcomes.…”

Section: Route Of Surgerymentioning

confidence: 98%

“…24 Countless studies have confirmed a higher risk of complications among non-White women after hysterectomy. 3,19,21,24,25 We must acknowledge that patients' preexisting conditions impact surgical outcomes. Black women often present with preexisting conditionings that include obesity, diabetes, and larger uterine weight, which increase the risk for adverse surgical outcomes.…”

Section: Route Of Surgerymentioning

confidence: 98%

“…Open surgery is often undertaken for anatomic limitations such as large uteri, but as Alexander and colleagues revealed, after adjusting for uterine size, prior pelvic surgery, and body mass index, Black women have more major and minor postoperative complications. 3,21,24 In fact race, specifically Black race, was independently associated with posthysterectomy admission, surgical site infections, and gastrointestinal complications. Hispanic heritage was similarly associated with 30-day hospitalizations, while patients of Asian/Pacific Islander descent had increased rates of urological injury.…”

Section: Route Of Surgerymentioning

confidence: 99%

“…In fact race, specifically Black race, was independently associated with posthysterectomy admission, surgical site infections, and gastrointestinal complications. Hispanic heritage was similarly associated with 30-day hospitalizations, while patients of Asian/Pacific Islander descent had increased rates of urological injury 24. Countless studies have confirmed a higher risk of complications among non-White women after hysterectomy 3,19,21,24,25.…”

Section: Introductionmentioning

confidence: 97%

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Disparities in Benign Gynecologic Surgical Care

Laughman

Ogu

Warner

et al. 2022

Clinical Obstetrics &Amp; Gynecology

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A person’s health is not only affected by their disease states, but also the quality of care and posttreatment sequelae. Research shows that disparities exist in benign gynecologic surgery access to care, techniques, and perioperative outcomes. Surgical education, pathways that emphasize minimally invasive approaches, and patient-centered care that recognizes historical influences on patient perspectives are critical to dampening these disparities.

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Racial/Ethnic Differences in the Risk of Surgical Complications and Posthysterectomy Hospitalization among Women Undergoing Hysterectomy for Benign Conditions

Cited by 14 publications

References 43 publications

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Disparities in Benign Gynecologic Surgical Care

Hysterectomy inequities between black and white patients in the US military health system: A retrospective cohort study

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