NEW YORK (Reuters Health) - African-American patients are approximately twice as likely as their Caucasian counterparts to die following major liver surgery, or hepatectomy, U.S. researchers report.
Exactly why this is the case is unclear, but it does not seem to relate to clinical factors, hospital factors, or insurance status, according to the report in the Journal of the American College of Surgery.
“Our study shows a racial divide in regards to in-hospital mortality after major hepatectomy,” senior author Dr. Timothy Pawlik, from Johns Hopkins University School of Medicine in Baltimore, said in a statement. “This finding is of special note because of the magnitude of the observed gap in outcomes.”
Pawlik’s team analyzed hospital discharge data for 3,552 patients who were entered in the Nationwide Inpatient Sample and underwent major hepatectomy from 1998 to 2005. Of the subjects, 59 percent were Caucasian, 6 percent African-American, 5 percent Hispanic, 7 percent Asian/Pacific Islander, and 24 percent other or unknown.
After adjusting for potential confounders, in-hospital mortality was 2.15-times higher among African Americans compared with Caucasians. Moreover, as mentioned, a racial gap was still apparent after further analyses were performed based on patient factors, such as other insurance status and hospital caseload.
“There has previously not been any research on racial disparities in the outcomes of liver resection,” lead author Dr. Hari Nathan, also from Johns Hopkins, said in a statement, but this issue is important to examine because the rates of liver resection, or surgery, have increased dramatically in the
Nathan added that further research is needed to better understand the cause of this racial disparity and the best means to intervene.
SOURCE: Journal of the American College of Surgery, September 2008.
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