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Characterizing Short-Term Outcomes Following Surgery for Rectal Cancer: the Role of Race and Insurance Status

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

There is a paucity of data demonstrating the effect race and insurance status have on postoperative outcomes for patients with rectal cancer. We evaluated factors impacting short-term outcomes following rectal cancer surgery.

Design

Patients who underwent surgery for rectal cancer using the University Health System Consortium database from 2011 to 2012 were studied. Univariate and multivariable analyses were used to identify patient related risk factors for 30-day outcomes after proctectomy: complication rate, 30-day readmission, ICU stay, and length of hospital stay (LOS).

Results

A total of 9272 proctectomies were identified in this cohort. After adjustment for potential confounders, black patients were more likely to have 30-day readmissions (OR 1.51, 95 % CI 1.26–1.81), ICU stays (OR 1.25, 95 % CI 1.03–1.51), and longer LOS (+1.67 days, 95 % CI 1.21–2.13) when compared to whites. Compared to those with private insurance, patients with public or military insurance or who were self-pay had a higher likelihood of having postoperative complications.

Conclusions

In patients who undergo elective proctectomy for rectal cancer, non-white and non-privately insured status are associated with significantly worse short-term outcomes. Further studies are needed to determine the implications with respect to receipt of adjuvant therapy and survival.

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Author contributions

Study conception and design: Chan, Damle, Davids, Suwanabol, Sturrock, Sweeney, Maykel, Alavi

Acquisition of data: Damle, Suwanabol, Alavi

Analysis and Interpretation of data: Chan, Damle, Suwanabol, Alavi

Drafting of manuscript: Chan, Suwanabol, Alavi

Critical revisions: Damle, Davids, Sturrock, Sweeney, Maykel

Final Approval: Chan, Damle, Davids, Suwanabol, Sturrock, Sweeney, Maykel, Alavi

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Author notes

    Authors and Affiliations

    1. Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA

      Sook Y. Chan, Rachelle N. Damle, Jennifer S. Davids, Paul R. Sturrock, W. Brian Sweeney, Justin A. Maykel & Karim Alavi

    2. Division of Colon and Rectal Surgery, Department of Surgery, University of Michigan, 2124 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

      Pasithorn A. Suwanabol

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    1. Sook Y. Chan
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    2. Pasithorn A. Suwanabol
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    3. Rachelle N. Damle
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    4. Jennifer S. Davids
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    5. Paul R. Sturrock
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    6. W. Brian Sweeney
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    7. Justin A. Maykel
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    8. Karim Alavi
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    Correspondence to Sook Y. Chan.

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    The authors have no conflicts or disclosures to report.

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    The authors have no funding sources to disclose.

    Additional information

    Sook Y. Chan M.D. and Pasithorn A. Suwanabol M.D. contributed equally to this work.

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    Chan, S.Y., Suwanabol, P.A., Damle, R.N. et al. Characterizing Short-Term Outcomes Following Surgery for Rectal Cancer: the Role of Race and Insurance Status. J Gastrointest Surg 20, 1891–1898 (2016). https://doi.org/10.1007/s11605-016-3241-9

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    • DOI: https://doi.org/10.1007/s11605-016-3241-9

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