TY - JOUR
T1 - Disparities influencing rates of urgent/emergent surgery for diverticulitis in the state of Florida
AU - Lemini, Riccardo
AU - Spaulding, Aaron C.
AU - Osagiede, Osayande
AU - Cochuyt, Jordan J.
AU - Naessens, James M.
AU - Crandall, Marie
AU - Cima, Robert R.
AU - Colibaseanu, Dorin T.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/6
Y1 - 2020/6
N2 - Background: Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated disparities regarding access to Minimally Invasive Surgery (MIS) and development of complications. Methods: The Florida Inpatient Discharge Dataset was queried for patients diagnosed with diverticulitis. Three multivariate models were utilized: 1) elective vs urgent/emergent surgery, 2) MIS vs open and 3) presence of complications. Results: The analysis included 12,654 patients. Factors associated with increased odds of urgent/emergent care included being uninsured or covered by Medicaid, African American, obese, or more comorbid. MIS was associated with reduced odds of complications. Patients treated by high-volume or colorectal surgeons had increased odds of receiving MIS. Conclusions: Patients were more likely to receive MIS if they were treated by a colorectal surgeon, or a high-volume surgeon (colorectal, or general surgeon). Additionally, patients that were older, had increased comorbidities, or did not have health insurance were less likely to receive MIS.
AB - Background: Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated disparities regarding access to Minimally Invasive Surgery (MIS) and development of complications. Methods: The Florida Inpatient Discharge Dataset was queried for patients diagnosed with diverticulitis. Three multivariate models were utilized: 1) elective vs urgent/emergent surgery, 2) MIS vs open and 3) presence of complications. Results: The analysis included 12,654 patients. Factors associated with increased odds of urgent/emergent care included being uninsured or covered by Medicaid, African American, obese, or more comorbid. MIS was associated with reduced odds of complications. Patients treated by high-volume or colorectal surgeons had increased odds of receiving MIS. Conclusions: Patients were more likely to receive MIS if they were treated by a colorectal surgeon, or a high-volume surgeon (colorectal, or general surgeon). Additionally, patients that were older, had increased comorbidities, or did not have health insurance were less likely to receive MIS.
KW - Colorectal surgery
KW - Complicated diverticulitis
KW - Disparities
KW - Minimally invasive surgery
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U2 - 10.1016/j.amjsurg.2019.09.005
DO - 10.1016/j.amjsurg.2019.09.005
M3 - Article
C2 - 31526510
AN - SCOPUS:85072083679
SN - 0002-9610
VL - 219
SP - 1012
EP - 1018
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -