Evaluating Racial Disparities in 30-day Outcomes for African Americans Following Colectomy for Volvulus.

Abstract

Background: Surgery is the definitive treatment for colonic volvulus despite initial decompression therapy. In general surgery, African Americans were found to have higher risks of mortality and morbidities. However, racial disparity in colectomy outcomes for volvulus among African Americans had not been explored. This study examined the 30-day outcomes for African Americans following colectomy for volvulus.

Methods: The National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2022 was used. Only patients with volvulus as the primary indication for colectomy were selected. A 1:1 propensity score matching was applied to African Americans and Caucasians to match sex, age, baseline characteristics, preoperative preparation, indication for surgery (if emergent), and operative approaches. Thirty-day postoperative outcomes were examined.

Results: There were 1027 and 7451 African Americans and Caucasians who underwent colectomy for volvulus, respectively. All African Americans were 1:1 propensity-score matched to their Caucasian counterparts. African Americans and Caucasians had a comparable mortality rate (7.21% vs 7.89%, P = 0.62). While African Americans had a higher risk of pulmonary complications (16.85% vs 13.53%, P = 0.04), other surgical complications were all comparable between African Americans and Caucasians. However, African Americans had a longer time from admission to operation (2.70 ± 3.99 vs 2.17 ± 3.36 days, P < 0.01) and a longer length of stay (LOS; 12.81 ± 10.28 vs 10.50 ± 7.72 days, P < 0.01).

Conclusion: African Americans were found to have higher risks of pulmonary complications, delayed operation, and extended LOS. These disparities raise concerns and warrant further investigation into their underlying causes. Effective targeted interventions may be necessary to address these issues.