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Journal of Gastrointestinal Surgery

, Volume 22, Issue 2, pp 250–258 | Cite as

Racial Disparities After Stoma Construction Exist in Time to Closure After 1 Year but Not in Overall Stoma Reversal Rates

  • Drew J. GunnellsJr.
  • Lauren N. Wood
  • Lauren Goss
  • Melanie S. Morris
  • Gregory D. Kennedy
  • Jamie A. Cannon
  • Daniel I. ChuEmail author
2017 SSAT Plenary Presentation

Abstract

Introduction

Conflicting data exist on racial disparities in stoma reversal (SR) rates. Our aim was to investigate the role of race in SR rates, and time to closure, in a longitudinal, racially diverse database.

Methods

All adult patients (>18 years) who received an ileostomy or colostomy from 1999 to 2016 at a single institution were identified. Primary outcomes were SR rates and time to closure. Failure to reverse and time to closure was modeled using Cox regression. Kaplan-Meier survival curves, stratified by race, were generated for time to closure and hazard ratios (HRs) calculated.

Results

Of 770 patients with stomas, 65.6% of patients underwent SR; 76.6% were white and 23.4% were black. On adjusted analysis, race did not predict overall SR rates or time to closure if performed less than 1 year. Instead, significant predictors for failure in SR included age, insurance status, end colostomy/ileostomy, and loop colostomy (p < 0.05). Predictors of delay in time to closure included insurance, end colostomy/ileostomy, and loop colostomy (p < 0.05). In patients who underwent reversal after 1 year, black race was an independent predictor of time to closure (HR 0.21, 95% CI 0.07–0.63, p < 0.05).

Conclusion

SR rates were equal between black and white patients. Disparities in time to closure existed only for black patients if reversed more than 1 year after index stoma construction. While equitable outcomes were achieved for most patients, further investigation is necessary to understand stoma disparities after 1 year.

Keywords

Racial disparities Stomas Ostomy reversal Time to closure 

Notes

Contributions

All authors contributed to the conception and design, data analysis/interpretation, and drafting/final approval of the publication.

Compliance with Ethical Standards

Disclaimers

None.

Grant Support

None.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  • Drew J. GunnellsJr.
    • 1
  • Lauren N. Wood
    • 1
  • Lauren Goss
    • 1
  • Melanie S. Morris
    • 1
  • Gregory D. Kennedy
    • 1
  • Jamie A. Cannon
    • 1
  • Daniel I. Chu
    • 1
    Email author
  1. 1.Division of Gastrointestinal Surgery, Department of SurgeryUniversity of Alabama at BirminghamBirminghamUSA

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