Tuesday 9 September 2008

After A Liver Operation, African-Americans At Twice The Risk Of Death As Caucasians

�New research published in the Journal of the American College of Surgeons shows African Americans ar more than twice as likely as Caucasians to die in the infirmary after surgical removal of part of the liver -- an increasingly used procedure for the treatment of liver cancer.



In recent years, a large body of evidence has emerged revealing significant racial disparities in health care and outcomes in the United States. Previous studies get documented racial disparities in surgical mortality after cardiovascular and cancer the Crab procedures. Because of such studies, the identification and elimination of these disparities has go a national public health priority.



"Our study shows a racial divide in regards to in-hospital mortality afterwards major hepatectomy," according to Timothy Pawlik, MD, MPH, FACS, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md. "This finding is of special note because of the magnitude of the observed gap in outcomes."



Using hospital discharge data from the Nationwide Inpatient Sample, researchers retrospectively reviewed 3,552 patients who underwent major hepatectomy between 1998 and 2005. The overall racial makeup was 59 percent Caucasian, 6 pct African-American, 5 percent Hispanic, 7 percentage Asian/Pacific Islander and 24 percent other or unsung, which included records with missing race and those from states that do not report race.



"There has previously not been any research on racial disparities in the outcomes of liver resection, but it is an important issue to examine as the use of hepatic resection has increased dramatically in the U.S.," added Hari Nathan, MD, department of surgery, Johns Hopkins University School of Medicine and the study's lead investigator. "Given this increase, studies are needful to clear up the nature of this disparity and identify targets for intervention."



The odds of dying following this type of liver operation were twice as high for African Americans compared with Caucasians. After adjustment for clinical, infirmary, and socioeconomic risk factors, data revealed that African-American patients were twice as likely to die compared to Caucasian patients (odds ratio 2.15, 95 percent assurance, interval 1.28 to 3.61).



Researchers believe that differences in preoperative health status may underlie some of the ascertained disparity in outcomes, a theory supported by the finding that African-American patients who died in the hospital as a complication of a hepatectomy did so a great deal sooner than their Caucasian counterparts. Hospital factors may also explain racial disparities in outcomes, insofar as minority patients might receive care at hospitals with generally poorer outcomes.





About the American College of Surgeons




The American College of Surgeons is a scientific and educational organisation of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 72,000 members and is the largest organisation of surgeons in the world. For more information, visit http://www.facs.org/.



Source: Sally Garneski

Weber Shandwick Worldwide



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