Associations of gender, race, and ethnicity with disparities in short-term adverse outcomes after pancreatic resection for cancer
Jonathan Pastrana Del Valle MD
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorDavid A. Mahvi MD
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorMark Fairweather MD
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorJiping Wang MD PhD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorThomas E. Clancy MD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorStanley W. Ashley MD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorRichard D. Urman MD MBA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorEdward E. Whang MD FACS
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorCorresponding Author
Jason S. Gold MD FACS
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Correspondence Jason S. Gold, MD, FACS, Department of Surgical Service, VA Boston Healthcare System, 1400 VFW Pkwy, West Roxbury, MA 02132, USA.
Email: [email protected]
Search for more papers by this authorJonathan Pastrana Del Valle MD
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorDavid A. Mahvi MD
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorMark Fairweather MD
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorJiping Wang MD PhD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorThomas E. Clancy MD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorStanley W. Ashley MD FACS
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorRichard D. Urman MD MBA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorEdward E. Whang MD FACS
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorCorresponding Author
Jason S. Gold MD FACS
Department of Surgical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Correspondence Jason S. Gold, MD, FACS, Department of Surgical Service, VA Boston Healthcare System, 1400 VFW Pkwy, West Roxbury, MA 02132, USA.
Email: [email protected]
Search for more papers by this authorNote: Accepted for presentations at Association of VA Surgeons 2020 meeting.
Abstract
Background
Several studies have identified disparities in pancreatic cancer treatment associated with gender, race, and ethnicity. There are limited data examining disparities in short-term adverse outcomes after pancreatic resection for cancer. The aim of this study is to evaluate associations of gender, race, and ethnicity with morbidity and mortality after pancreatic resection for malignancy.
Methods
The American College of Surgeons National Surgical Quality Improvement database was retrospectively reviewed. The χ2 test and Student's t-test were used for univariable analysis and hierarchical logistic regression for multivariable analysis.
Results
Morbidity and major morbidity after pancreaticoduodenectomy are associated with male gender, Asian race, and Hispanic ethnicity, whereas 30-day mortality is associated with the male gender. Morbidity and major morbidity after distal pancreatectomy are associated with the male gender. Morbidity after pancreaticoduodenectomy is independently associated with male gender, Asian race, and Hispanic ethnicity; major morbidity is independently associated with male gender and Asian race, and mortality is independently associated with Hispanic ethnicity.
Conclusions
Gender, race, and ethnicity are independently associated with morbidity after pancreaticoduodenectomy for cancer; gender and race are independently associated with major morbidity; and ethnicity is independently associated with mortality. Further studies are warranted to determine the basis of these associations.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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