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Surgery for diverticulitis led to worse outcomes among blacks vs. whites
Schneider EB. Arch Surg. 2011;doi:10.1001/archsurg.2011.280.
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Black patients who underwent surgery for diverticulitis were more likely to require emergency surgery, experience comorbid conditions and were at increased risk for mortality when compared with whites undergoing the same procedure.
“We need to determine why these treatment and outcome differences exist, even though everyone in the population studied was covered by the same basic insurance,” Eric B. Schneider, PhD, of the Center for Surgical Trials and Outcomes Research at The Johns Hopkins School of Medicine, told Infectious Disease News.
Schneider and colleagues pooled Medicare Provider Analysis and Review data to assess disparities in elective vs. emergency procedures, and mortality among patients aged 65 years and older undergoing surgery for diverticulitis.
There were 2,283 black patients and 49,937 white patients eligible for the study.
Blacks were aged younger (74.7 years vs. 75.5 years; P<.001) and more likely to be female (75.2% vs. 69.8%; P<.001) than whites.
Compared with whites, blacks had more comorbidities (0.87 vs. 0.98; P<.001), emergency procedures (54.7% vs. 67.8%; P<.001) and in-hospital mortality (5% vs. 6.8%; P<.001).
After adjusting for age, sex and medical comorbidities, researchers found that blacks were 26% more likely to be admitted for emergency surgery and were at a 28% increased risk for in-hospital mortality.
“These findings suggest that observed racial disparities encompass more than just insurance status and medical comorbidity,” the researchers wrote in the study. “Mechanisms leading to worse outcomes for blacks must be elucidated.” – by Ashley DeNyse
Disclosure: The researchers report no relevant financial disclosures.
Studies of racial health disparities are finding important medical areas that need further research. It is not clear if there are genetic reasons for the worse post-surgery prognosis for diverticulitis in blacks compared with whites, if they have more advanced diverticular disease at the time of the initial surgery, or that there is another explanation.
- Herbert L. DuPont, MD
Infectious Disease News Editorial Board member
Disclosure: Dr. DuPont reports no relevant financial disclosures.
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