4.7 Article

Racial/Ethnic Disparities in Perioperative Outcomes of Major Procedures Results From the National Surgical Quality Improvement Program

期刊

ANNALS OF SURGERY
卷 262, 期 6, 页码 955-964

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SLA.0000000000001078

关键词

ACS-NSQIP; cancer surgery; major noncancer surgery; perioperative outcomes; race; ethnicity

类别

资金

  1. Prof Walter Morris-Hale Distinguished Chair in Urologic Oncology at Brigham and Women's Hospital

向作者/读者索取更多资源

Objective:To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States.Background:Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several types of major cardiac, general, vascular, orthopedic, and cancer surgical procedures. However, recent evidence suggests attenuation of these racial/ethnic differences, particularly at academic institutions.Methods:We utilized the American College of Surgeons National Surgical Quality Improvement Program database to identify 142,344 patients undergoing one of the 16 major cancer and noncancer surgical procedures between 2005 and 2011.Results:Eighty-five percent of the cohort was white, with black and Hispanic individuals comprising 8% and 4%, respectively. In multivariable analyses, black patients had greater odds of experiencing prolonged length of stay after 10 of the 16 procedures studied (all P<0.05), though there was no disparity in odds of 30-day mortality after any surgery. Hispanics were more likely to experience prolonged length of stay after 5 surgical procedures (all P<0.04), and were at greater odds of dying within 30 days after colectomy, heart valve repair/replacement, or abdominal aortic aneurysm repair (all P<0.03). Fewer disparities were observed for Hispanics, than for black patients, and also for cancer, than for noncancer surgical procedures.Conclusions:Important racial/ethnic disparities in perioperative outcomes were observed among patients undergoing major cancer and noncancer surgical procedures at American College of Surgeons National Surgical Quality Improvement Program institutions. There were fewer disparities among individuals undergoing cancer surgery, though black patients, in particular, were more likely to experience prolonged length of stay.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

Article Oncology

Impact of timing on salvage radiation therapy adverse events following radical prostatectomy: A secondary analysis of the RTOG 9601 cohort

Lee Baumgarten, Alex Borchert, Akshay Sood, Deepansh Dalela, Sohrab Arora, Jacob Keeley, Craig Rogers, James Peabody, Mani Menon, Firas Abdollah

UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS (2020)

Letter Urology & Nephrology

Extended pelvic lymph-node dissection is independently associated with improved overall survival in patients with prostate cancer at high-risk of lymph-node invasion

Akshay Sood, Jacob Keeley, Isaac Palma-Zamora, Deepansh Dalela, Sohrab Arora, James O. Peabody, Craig G. Rogers, Francesco Montorsi, Mani Menon, Alberto Briganti, Firas Abdollah

BJU INTERNATIONAL (2020)

Article Oncology

Impact of Lymphovascular Invasion on Overall Survival in Patients With Prostate Cancer Following Radical Prostatectomy: Stage-per-Stage Analysis

Marcus Jamil, Nikola Rakic, Akshay Sood, Jacob Keeley, Daniele Modonutti, Giacomo Novara, Wooju Jeong, Mani Menon, Craig G. Rogers, Firas Abdollah

Summary: This study found that the presence of lymphovascular invasion (LVI) in prostate cancer patients has a negative impact on overall survival, especially in cases of pT3a and higher levels.

CLINICAL GENITOURINARY CANCER (2021)

Article Urology & Nephrology

Use of ultra-low dose computed tomography versus abdominal plain film for assessment of stone-free rates after shock-wave lithotripsy: implications on emergency room visits, surgical procedures, and cost-effectiveness

Akshay Sood, Philip Wong, Alex Borchert, Jeff Budzyn, Jacob Keeley, Chase Heilbronn, Ben Eilender, Raymond Littleton, David A. Leavitt

Summary: This study compared the performance of ultra-low dose computed tomography (ULD-CT) and abdominal plain film (KUB) in detecting residual stone-fragments in urolithiasis patients undergoing shock-wave lithotripsy (SWL). It was found that ULD-CT had a higher residual stone-fragment detection rate and reduced the need for emergency room visits and unplanned surgeries. In terms of cost-effectiveness, the ULD-CT follow-up pathway was economically favorable when ULD-CT charges were low.

UROLITHIASIS (2021)

Article Urology & Nephrology

The Impact of the Price Transparency Mandate on Cost Reporting for Common Urological Services across the U.S. News Top 21 Hospitals

Akshay Sood, Mohit Butaney, Phil Olson, Guillaume Farah, Craig G. Rogers, James O. Peabody, Mani Menon, Firas Abdollah

UROLOGY PRACTICE (2021)

Article Urology & Nephrology

Description of Surgical Technique and Oncologic and Functional Outcomes of the Precision Prostatectomy Procedure (IDEAL Stage 1-2b Study)

Akshay Sood, Wooju Jeong, Isaac Palma-Zamora, Firas Abdollah, Mohit Butaney, Nicholas Corsi, Hallie Wurst, Sohrab Arora, Naveen Kachroo, Oudai Hassan, Nilesh Gupta, Michael A. Gorin, Mani Menon

Summary: Precision prostatectomy is a novel focal therapy technique that offers excellent functional recovery and tumor control for patients with intermediate- or high-volume low-risk prostate cancer.

EUROPEAN UROLOGY (2022)

Editorial Material Oncology

ASO Visual Abstract: Anti-androgen Therapy Overcomes the Time Delay in Initiation of Salvage Radiation Therapy and Rescues the Oncological Outcomes in Men with Recurrent Prostate Cancer After Radical Prostatectomy-A Post Hoc Analysis of the RTOG 9601 Trial Data

Akshay Sood, Jacob Keeley, Isaac Palma-Zamora, Michael Chien, Nicholas Corsi, Wooju Jeong, Craig G. Rogers, Quoc-Dien Trinh, James O. Peabody, Mani Menon, Firas Abdollah

ANNALS OF SURGICAL ONCOLOGY (2022)

Article Oncology

Anti-Androgen Therapy Overcomes the Time Delay in Initiation of Salvage Radiation Therapy and Rescues the Oncological Outcomes in Men with Recurrent Prostate Cancer After Radical Prostatectomy: A Post Hoc Analysis of the RTOG-9601 Trial Data

Akshay Sood, Jacob Keeley, Isaac Palma-Zamora, Michael Chien, Nicholas Corsi, Wooju Jeong, Craig G. Rogers, Quoc-Dien Trinh, James O. Peabody, Mani Menon, Firas Abdollah

Summary: This study aimed to investigate the use of anti-androgen therapy in late salvage radiation therapy for prostate cancer patients with recurrence. The results showed that compared to early radiation therapy, late radiation therapy had poorer overall survival, cancer-specific mortality, and metastasis rates. However, when anti-androgen therapy was added to late radiation therapy, these negative outcomes were improved.

ANNALS OF SURGICAL ONCOLOGY (2022)

Article Endocrinology & Metabolism

Evaluating post radical prostatectomy mechanisms of early continence

Akshay Sood, Ralph Grauer, Wooju Jeong, Mohit Butaney, Anudeep Mukkamala, Alex Borchert, Lee Baumgarten, Patrick J. Hensley, Firas Abdollah, Mani Menon

Summary: This study compared the total continence outcomes of four different techniques of robot-assisted radical prostatectomy (RARP) to identify the periprostatic structures associated with early return of urinary continence. The results showed that the preservation of the bladder neck in the posterior and hybrid approaches was associated with the quickest recovery of urinary continence, while the transvesical approach, which preserved the space of Retzius but not the bladder neck, had the poorest continence rates. Bladder neck preservation was found to be the significant predictor of early continence recovery.

PROSTATE (2022)

Editorial Material Urology & Nephrology

A novel upper tract ureteroscopic biopsy technique: the form tackle

Dane E. Klett, Manaf Alom, Kevin Wymer, Aaron Potretzke

INTERNATIONAL BRAZ J UROL (2022)

Article Oncology

Optimizing anti-androgen treatment use among men with pathologic lymph-node positive prostate cancer treated with radical prostatectomy: the importance of postoperative PSA kinetics

Akshay Sood, Lawrence T. Zhang, Jacob Keeley, Mohit Butaney, Maxwell Stricker, Jack R. Andrews, Ralph Grauer, James O. Peabody, Craig G. Rogers, Mani Menon, Firas Abdollah

Summary: This study aimed to investigate the role of postoperative PSA kinetics and pathologic tumor characteristics in guiding the use of ADT in pN1 prostate cancer patients following radical prostatectomy. The study found that early postoperative PSA kinetics could provide valuable information for guiding the timing of ADT initiation, potentially reducing over- and undertreatment in pN1 prostate cancer men.

PROSTATE CANCER AND PROSTATIC DISEASES (2022)

Article Oncology

15-year biochemical failure, metastasis, salvage therapy, and cancer-specific and overall survival rates in men treated with robotic radical prostatectomy for PSA-screen detected prostate cancer

Akshay Sood, Ralph Grauer, Mireya Diaz-Insua, Ashutosh K. Tewari, Ashok K. Hemal, Alok Shrivastava, James O. Peabody, Wooju Jeong, Firas Abdollah, Jan K. Rudzinski, Jack R. Andrews, Michael A. Gorin, Mahendra Bhandari, Mani Menon

Summary: By analyzing 15-year follow-up data, we found that patients with clinically-localized prostate cancer who underwent robot-assisted laparoscopic prostatectomy achieved durable long-term oncological control.

PROSTATE CANCER AND PROSTATIC DISEASES (2023)

Article Oncology

Comparing Oncological and Perioperative Outcomes of Open versus Laparoscopic versus Robotic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Multicenter, Multinational, Propensity Score-Matched Analysis

Nico C. Grossmann, Francesco Soria, Tristan Juvet, Aaron M. Potretzke, Hooman Djaladat, Alireza Ghoreifi, Eiji Kikuchi, Andrea Mari, Zine-Eddine Khene, Kazutoshi Fujita, Jay D. Raman, Alberto Breda, Matteo Fontana, John P. Sfakianos, John L. Pfail, Ekaterina Laukhtina, Pawel Rajwa, Maximillian Pallauf, Cedric Poyet, Giovanni E. Cacciamani, Thomas van Doeveren, Joost L. Boormans, Alessandro Antonelli, Marcus Jamil, Firas Abdollah, Guillaume Ploussard, Axel Heidenreich, Enno Storz, Siamak Daneshmand, Stephen A. Boorjian, Morgan Roupret, Michael Rink, Shahrokh F. Shariat, Benjamin Pradere

Summary: The study compared perioperative and oncologic outcomes among patients who underwent open, laparoscopic, and robotic RNU for non-metastatic upper urinary tract urothelial carcinoma. The results showed worse bladder recurrence-free survival in patients who had laparoscopic and robotic RNU compared to open RNU. However, recurrence-free, cancer-specific, and overall survival were similar between the three surgical approaches. Laparoscopic and robotic RNU were associated with shorter hospital stay and fewer major postoperative complications. Further research is needed to investigate the factors responsible for the inferior bladder recurrence-free survival in patients treated with minimally invasive techniques.

CANCERS (2023)

Article Urology & Nephrology

Does MOSES pulse modulation reduce short-term catheter reinsertion following holmium laser enucleation of the prostate?

Dane E. Klett, Bryce Baird, Colleen T. Ball, Chandler D. Dora

Summary: This study found no association between short-term catheter reinsertion following HoLEP and MOSES pulse modulation. Catheter reinsertion events appear to be attributable to other factors.

INVESTIGATIVE AND CLINICAL UROLOGY (2021)

暂无数据