Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery

Drew J. Gunnells, Melanie S. Morris, Aerin DeRussy, Allison A. Gullick, Talha Malik, Jamie A. Cannon, Mary T. Hawn, Daniel I. Chu

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery. Design: The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression. Results: Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 % were readmitted within 30 days of index operation. Black patients constituted 7.7 % of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 %) and Crohn’s diagnosis (84 vs. 73 %) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 %) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 % confidence interval 1.1–2.5). Conclusions: Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.

Original languageEnglish (US)
Pages (from-to)985-993
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

Fingerprint

Patient Readmission
Colorectal Surgery
Inflammatory Bowel Diseases
Social Determinants of Health
Quality Improvement
Length of Stay
Colon
Logistic Models
Smoking
Odds Ratio
Databases
Confidence Intervals
Incidence
Health

Keywords

  • Inflammatory bowel disease
  • Racial disparities
  • Readmission
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery. / Gunnells, Drew J.; Morris, Melanie S.; DeRussy, Aerin; Gullick, Allison A.; Malik, Talha; Cannon, Jamie A.; Hawn, Mary T.; Chu, Daniel I.

In: Journal of Gastrointestinal Surgery, Vol. 20, No. 5, 01.05.2016, p. 985-993.

Research output: Contribution to journalArticle

Gunnells, Drew J. ; Morris, Melanie S. ; DeRussy, Aerin ; Gullick, Allison A. ; Malik, Talha ; Cannon, Jamie A. ; Hawn, Mary T. ; Chu, Daniel I. / Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery. In: Journal of Gastrointestinal Surgery. 2016 ; Vol. 20, No. 5. pp. 985-993.
@article{5114d720e05f4ccf83722be09a35004f,
title = "Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery",
abstract = "Background: The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery. Design: The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression. Results: Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 {\%} were readmitted within 30 days of index operation. Black patients constituted 7.7 {\%} of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 {\%}) and Crohn’s diagnosis (84 vs. 73 {\%}) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 {\%}) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 {\%} confidence interval 1.1–2.5). Conclusions: Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.",
keywords = "Inflammatory bowel disease, Racial disparities, Readmission, Surgery",
author = "Gunnells, {Drew J.} and Morris, {Melanie S.} and Aerin DeRussy and Gullick, {Allison A.} and Talha Malik and Cannon, {Jamie A.} and Hawn, {Mary T.} and Chu, {Daniel I.}",
year = "2016",
month = "5",
day = "1",
doi = "10.1007/s11605-015-3068-9",
language = "English (US)",
volume = "20",
pages = "985--993",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Racial Disparities in Readmissions for Patients with Inflammatory Bowel Disease (IBD) After Colorectal Surgery

AU - Gunnells, Drew J.

AU - Morris, Melanie S.

AU - DeRussy, Aerin

AU - Gullick, Allison A.

AU - Malik, Talha

AU - Cannon, Jamie A.

AU - Hawn, Mary T.

AU - Chu, Daniel I.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery. Design: The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression. Results: Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 % were readmitted within 30 days of index operation. Black patients constituted 7.7 % of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 %) and Crohn’s diagnosis (84 vs. 73 %) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 %) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 % confidence interval 1.1–2.5). Conclusions: Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.

AB - Background: The incidence of inflammatory bowel disease (IBD) in minorities is increasing, and health outcome disparities are becoming more apparent. Our aim was to investigate the contribution of race to readmissions in IBD patients undergoing colorectal surgery. Design: The National Surgical Quality Improvement Program database from 2012 to 2013 was queried for all patients with IBD undergoing elective colorectal surgery. After stratifying by race, unadjusted univariate and bivariate comparisons were made. Primary outcome was all-cause 30-day readmission. Predictors of readmission were identified using multivariable logistic regression. Results: Of the 2523 patients with IBD who underwent elective colon surgery, 15.0 % were readmitted within 30 days of index operation. Black patients constituted 7.7 % of the entire cohort. Black patients were significantly different in smoking status (27 vs. 22 %) and Crohn’s diagnosis (84 vs. 73 %) (p < 0.05). Black patients had significantly higher readmission rates (20 vs. 15 %) and longer length-of-stays (8 vs. 6 days) after surgery (p < 0.05). On multivariable analysis, black race remained a significant predictor for 30-day readmissions in patients with IBD (odds ratio 1.6, 95 % confidence interval 1.1–2.5). Conclusions: Black patients with IBD have an increased risk for readmission after colorectal surgery. Efforts to reduce readmissions need to target not only well-studied risk factors such as postoperative complications, but also investigate non-NSQIP-measured elements such as social and behavioral determinants of health.

KW - Inflammatory bowel disease

KW - Racial disparities

KW - Readmission

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84953408240&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84953408240&partnerID=8YFLogxK

U2 - 10.1007/s11605-015-3068-9

DO - 10.1007/s11605-015-3068-9

M3 - Article

C2 - 26743885

AN - SCOPUS:84953408240

VL - 20

SP - 985

EP - 993

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 5

ER -