Association of Race and Postoperative Outcomes in Patients with Inflammatory Bowel Disease

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2024 Sep 11

PMID 39261381

Authors

John J Newland

Margaret H Sundel

Kyle W Blackburn

Roumen Vessilenov

Samuel Eisenstein

Andrea C Bafford

Affiliations

Soon will be listed here.

Abstract

Background: Previous literature suggests that rates of postoperative complications following inflammatory bowel disease (IBD) surgery differ based on race.

Aims: The purpose of this study was to examine the association between race and adverse events and wound complications in patients with IBD.

Methods: This was a retrospective cohort study of the American College of Surgeons National Surgery Quality Improvement Program Inflammatory Bowel Disease Collaborative from 2017 to 2022. The data was collected from 15 high-volume IBD centers across the United States. The data was analyzed using crude and multivariable logistic regressions.

Results: 4284 patients were included in the study. Overall rates of adverse events and wound complications were 20.3% and 11.3%, respectively, and did not differ based on race on bivariate analysis. Rates of adverse events were 20.0% vs 24.6% vs 22.1%, p = 0.13 for white, black and other minority subjects, respectively. The adjusted odds of adverse events were higher for black subjects (1.46 [95%CI 1.0-2.1], p = 0.03) compared to white subjects. No difference in adverse events was found between other minority subjects and either black or white subjects (1.29 [0.7-2.3], p = 0.58). Race was not associated with likelihood of wound complications in the final analysis.

Conclusions: We found that a subset of black patients with IBD continue to experience more adverse events compared to white patients, primarily driven by a higher need for postoperative blood transfusion. Nonetheless, known risk factors, including comorbid conditions, decreased BMI, open surgery, and emergency surgery have a stronger association with postoperative complications than race alone.

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