Brittany N. Burton MD, MAS, MHS (is Anesthesiologist, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles (UCLA).), Janet O. Adeola MD (is Anesthesiologist, Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham & Women's Hospital, Boston.), Veena M. Do (is Medical Student, School of Medicine, University of California, San Diego.), Adam J. Milam MD, PhD (is Senior Associate Consultant and Associate Professor of Anesthesiology, Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix.), Maxime Cannesson MD, PhD (is Chair, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, UCLA.), Keith C. Norris MD, PhD (is Professor, Department of Medicine, David Geffen School of Medicine, UCLA.), Nicole E. Lopez MD (is Associate Professor, Division of Colorectal Surgery, Department of Surgery, University of California, San Diego.), Rodney A. Gabriel MD, MAS (is Associate Professor, Division of Regional Anesthesia, and Director, Division of Perioperative Informatics, University of California, San Diego. Please address correspondence to Brittany N. Burton)
{"title":"Differences in the Receipt of Regional Anesthesia Based on Race and Ethnicity in Colorectal Surgery","authors":"Brittany N. Burton MD, MAS, MHS (is Anesthesiologist, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles (UCLA).), Janet O. Adeola MD (is Anesthesiologist, Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham & Women's Hospital, Boston.), Veena M. Do (is Medical Student, School of Medicine, University of California, San Diego.), Adam J. Milam MD, PhD (is Senior Associate Consultant and Associate Professor of Anesthesiology, Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix.), Maxime Cannesson MD, PhD (is Chair, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, UCLA.), Keith C. Norris MD, PhD (is Professor, Department of Medicine, David Geffen School of Medicine, UCLA.), Nicole E. Lopez MD (is Associate Professor, Division of Colorectal Surgery, Department of Surgery, University of California, San Diego.), Rodney A. Gabriel MD, MAS (is Associate Professor, Division of Regional Anesthesia, and Director, Division of Perioperative Informatics, University of California, San Diego. Please address correspondence to Brittany N. Burton)","doi":"10.1016/j.jcjq.2024.01.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Health equity in pain management during the perioperative period continues to be a topic of interest. The authors evaluated the association of race and ethnicity with regional anesthesia in patients who underwent colorectal surgery and characterized trends in regional anesthesia.</p></div><div><h3>Methods</h3><p>Using the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2020, the research team identified patients who underwent open or laparoscopic colorectal surgery. Associations between race and ethnicity and use of regional anesthesia were estimated using logistic regression models.</p></div><div><h3>Results</h3><p>The final sample size was 292,797, of which 15.6% (<em>n</em> = 45,784) received regional anesthesia. The unadjusted rates of regional anesthesia for race and ethnicity were 15.7% white, 15.1% Black, 12.8% Asian, 29.6% American Indian or Alaska Native, 16.3% Native Hawaiian or Pacific Islander, and 12.4% Hispanic. Black (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.90–0.96, <em>p</em> < 0.001) and Asian (OR 0.76, 95% CI 0.71–0.80, <em>p</em> < 0.001) patients had lower odds of regional anesthesia compared to white patients. Hispanic patients had lower odds of regional anesthesia compared to non-Hispanic patients (OR 0.72, 95% CI 0.68–0.75, <em>p</em> < 0.001). There was a significant annual increase in regional anesthesia from 2015 to 2020 for all racial and ethnic cohorts (<em>p</em> < 0.05).</p></div><div><h3>Conclusion</h3><p>There was an annual increase in the use of regional anesthesia, yet Black and Asian patients (compared to whites) and Hispanics (compared to non-Hispanics) were less likely to receive regional anesthesia for colorectal surgery. These differences suggest that there are racial and ethnic differences in regional anesthesia use for colorectal surgery.</p></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 6","pages":"Pages 416-424"},"PeriodicalIF":2.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725024000047","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Health equity in pain management during the perioperative period continues to be a topic of interest. The authors evaluated the association of race and ethnicity with regional anesthesia in patients who underwent colorectal surgery and characterized trends in regional anesthesia.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2020, the research team identified patients who underwent open or laparoscopic colorectal surgery. Associations between race and ethnicity and use of regional anesthesia were estimated using logistic regression models.
Results
The final sample size was 292,797, of which 15.6% (n = 45,784) received regional anesthesia. The unadjusted rates of regional anesthesia for race and ethnicity were 15.7% white, 15.1% Black, 12.8% Asian, 29.6% American Indian or Alaska Native, 16.3% Native Hawaiian or Pacific Islander, and 12.4% Hispanic. Black (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.90–0.96, p < 0.001) and Asian (OR 0.76, 95% CI 0.71–0.80, p < 0.001) patients had lower odds of regional anesthesia compared to white patients. Hispanic patients had lower odds of regional anesthesia compared to non-Hispanic patients (OR 0.72, 95% CI 0.68–0.75, p < 0.001). There was a significant annual increase in regional anesthesia from 2015 to 2020 for all racial and ethnic cohorts (p < 0.05).
Conclusion
There was an annual increase in the use of regional anesthesia, yet Black and Asian patients (compared to whites) and Hispanics (compared to non-Hispanics) were less likely to receive regional anesthesia for colorectal surgery. These differences suggest that there are racial and ethnic differences in regional anesthesia use for colorectal surgery.
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