Disparities/Minority Health

Study identifies factors contributing to more surgical complications among black patients

The National Healthcare Disparities Report, released by the Agency for Healthcare Research and Quality last year, showed that blacks suffer from more postoperative complications and injuries than whites even after adjustment for age, sex, and other factors affecting complications. A new study of hospitalized patients in New York State confirmed that blacks had higher rates of surgical complications than whites. The study, supported by the Agency for Healthcare Research and Quality (HS10910), showed higher complication rates among blacks were primarily due to more coexisting illnesses and longer hospital stays as well as the type of hospital.

Kevin Fiscella, M.D., M.P.H., of the University of Rochester School of Medicine & Dentistry, and colleagues used data from the New York State Inpatient Data Set of hospitalized patients from 1998-2000 to examine the effect of black race on risk of any surgical complication. Following adjustment for patient age and sex, black patients had 65 percent higher odds for a surgical complication than white patients.

However, further adjustment for coexisting illness and hospital length of stay reduced the higher odds of surgical complications among black patients to 18 percent. Additional adjustment for hospital characteristics (region of the state, percent of black and Medicaid annual discharges, and average income of admitted patients) essentially eliminated the increased risk of surgical complications for blacks. These results suggest that hospital factors may contribute to racial disparities in surgical complications in New York State. It is not clear the extent to which these findings apply to other states.

See "Racial disparity in surgical complications in New York State," by Dr. Fiscella, Peter Franks, M.D., Sean Meldrum, M.S., and Steven Barnett, M.D., in the August 2005 Annals of Surgery 242(2), pp. 151-155.

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