Association of non-English as primary language on clinical outcomes for arteriovenous fistula creation within a safety net system

Abstract

Approximately 22 ​% of the United States population communicates in a non-English language, potentially impacting healthcare communication and outcomes. Few studies have examined the association between non-English primary language (NEPL) and surgical outcomes and none to our knowledge in patients undergoing arteriovenous fistula creation within a safety net system. In this study, we conducted a retrospective analysis on adults who underwent AVF creation for hemodialysis access between January 1, 2014, and December 31, 2019. We employed a bivariate logistic regression analysis to assess the relationship between primary language and 30-day ED visits and readmissions, both for all-cause after AVF surgery and those specifically related to arteriovenous fistula (AVF) complications and a multivariate logistic regression to adjust for any cofounders. Among the study population of 1502 patients, 70 ​% were NEPL and predominantly self-identified as Hispanic/Latino. Despite the older age and higher prevalence of diabetes among NEPL patients, there was no statistically significant association of NEPL with 30-day readmission or ED visits post-AVF creation. The availability of certified translators and diverse array of healthcare professionals may have contributed to these findings. Nonetheless, further investigation is warranted to elucidate the impact of language discordance on post-surgical outcomes.