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Open AccessArticle
Racial Disparities in Bowel Preparation and Post-Operative Outcomes in Colorectal Cancer Patients
by
Alexandra E. Hernandez
Alexandra E. Hernandez 1,2,*,
Matthew Meece
Matthew Meece 1,2,
Kelley Benck
Kelley Benck 3,
Gianna Bello
Gianna Bello 3,
Carlos Theodore Huerta
Carlos Theodore Huerta 1,2,
Brianna L. Collie
Brianna L. Collie 1,2
,
Jennifer Nguyen
Jennifer Nguyen 4 and
Nivedh Paluvoi
Nivedh Paluvoi 1,2,5,*
1
Department of Surgery, University of Miami Health System, Miami, FL 33136, USA
2
DeWitt Daughtry Family Department of Surgery, Jackson Health System, Miami, FL 33136, USA
3
Miller School of Medicine, University of Miami, Miami, FL 33136, USA
4
Surgical Health Outcomes Consortium (SHOC), AdventHealth Digestive Health Institute, Orlando, FL 32806, USA
5
Division of Colorectal Surgery, Department of Surgery, University of Miami, Miami, FL 33136, USA
*
Authors to whom correspondence should be addressed.
Healthcare 2024, 12(15), 1513; https://doi.org/10.3390/healthcare12151513 (registering DOI)
Submission received: 22 May 2024
/
Revised: 22 July 2024
/
Accepted: 26 July 2024
/
Published: 30 July 2024
Abstract
Background: Combined pre-operative bowel preparation with oral antibiotics (OAB) and mechanical bowel preparation (MBP) is the current recommendation for elective colorectal surgery. Few have studied racial disparities in bowel preparation and subsequent post-operative complications. Methods: This retrospective cohort study used 2015–2021 ACS-NSQIP-targeted data for elective colectomy for colon cancer. Multivariate regression evaluated predictors of post-operative outcomes: post-operative ileus, anastomotic leak, surgical site infection (SSI), operative time, and hospital length of stay (LOS). Results: 72,886 patients were evaluated with 82.1% White, 11.1% Black, and 6.8% Asian or Asian Pacific Islander (AAPI); 4.2% were Hispanic and 51.4% male. Regression accounting for age, sex, ASA classification, comorbidities, and operative approach showed Black, AAPI, and Hispanic patients were more likely to have had no bowel preparation compared to White patients receiving MBP+OAB. Compared to White patients, Black and AAPI patients had higher odds of prolonged LOS and pro-longed operative time. Black patients had higher odds of post-operative ileus. Conclusions: Racial disparities exist in both bowel preparation administration and post-operative complications despite the method of bowel preparation. This warrants exploration into discriminatory bowel preparation practices and potential differences in the efficacy of bowel preparation in specific populations due to biological or social differences, which may affect outcomes. Our study is limited by its use of a large database that lacks socioeconomic variables and patient data beyond 30 days.
Share and Cite
MDPI and ACS Style
Hernandez, A.E.; Meece, M.; Benck, K.; Bello, G.; Huerta, C.T.; Collie, B.L.; Nguyen, J.; Paluvoi, N.
Racial Disparities in Bowel Preparation and Post-Operative Outcomes in Colorectal Cancer Patients. Healthcare 2024, 12, 1513.
https://doi.org/10.3390/healthcare12151513
AMA Style
Hernandez AE, Meece M, Benck K, Bello G, Huerta CT, Collie BL, Nguyen J, Paluvoi N.
Racial Disparities in Bowel Preparation and Post-Operative Outcomes in Colorectal Cancer Patients. Healthcare. 2024; 12(15):1513.
https://doi.org/10.3390/healthcare12151513
Chicago/Turabian Style
Hernandez, Alexandra E., Matthew Meece, Kelley Benck, Gianna Bello, Carlos Theodore Huerta, Brianna L. Collie, Jennifer Nguyen, and Nivedh Paluvoi.
2024. "Racial Disparities in Bowel Preparation and Post-Operative Outcomes in Colorectal Cancer Patients" Healthcare 12, no. 15: 1513.
https://doi.org/10.3390/healthcare12151513
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