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International Journal of Colorectal Disease

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01-08-2014 | Original Article

A comparison of abdominal surgical outcomes between African–American and Caucasian Crohn’s patients

Authors: Nicole Griglione, Shadi Yarandi, Jahnavi Srinivasan, Thomas Ahearn, Tanvi Dhere

Published in: International Journal of Colorectal Disease | Issue 8/2014

Abstract

Background and objective

Whether race affects the natural history of Crohn’s disease is a matter of debate. The aim of the current study was to evaluate the differences in surgical outcomes between African–American (AA) and Caucasian (C) Crohn’s patients undergoing surgery at a tertiary care referral center.

Methods

With Institutional Review Board approval, the medical records of our institution were queried to identify consecutive AA and C patients who underwent surgery for Crohn’s disease from December 1, 2009 to December 15, 2011. A retrospective chart review was performed using electronic medical records.

Results

A total of 77 patients were included in this study, including 32 AA (41 %) and 45 C (59 %). No significant differences were seen with respect to age, gender, type of insurance, preoperative exposure to immunosuppressives, body mass index, or smoking history between the two populations (p > 0.05). There was a trend toward lower albumin in AAs (p = 0.09). AA and C patients who underwent their first Crohn’s disease (CD)-related surgery had similar lag periods between diagnosis and surgery. No significant differences were seen in location of disease, indication for operation, and need for open laparotomy over laparoscopy. No significant differences were seen in need for a repeat operation within 90 days of the original surgery or major postoperative complications. There was a trend toward higher rate of minor complications in the AA group (p = 0.07).

Conclusion

No significant differences were noted in the current study in several preoperative variables and surgical outcomes between AA and C.

Kurata JH, Kantor-Fish S, Frankl H et al (1992) Crohn’s disease among ethnic groups in a large health maintenance organization. Gastroenterology 102:1940–1948PubMed

White JM, O’Connor S, Winter HS et al (2008) Inflammatory bowel disease in African American children compared with other racial/ethnic groups in a multicenter registry. Clin Gastroenterol Hepatol 6:1361–1369PubMedCentralPubMedCrossRef

Reddy SI, Burakoff R (2003) Inflammatory bowel disease in African Americans. Inflamm Bowel Dis 9:380–385PubMedCrossRef

Nguyen GC, Torres EA, Regueiro M et al (2006) Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanic Whites: characterization of a large North American cohort. Am J Gastroenterol 101:1012–1023PubMedCrossRef

Basu D, Lopez I, Kulkarni A, Sellin JH (2005) Impact of race and ethnicity on inflammatory bowel disease. Am J Gastroenterol 100:2254–2261PubMedCrossRef

Cross RK, Jung C, Wasan S et al (2006) Racial differences in disease phenotypes in patients with Crohn’s disease. Inflamm Bowel Dis 12:192–198PubMedCrossRef

Nguyen GC, Bayless TM, Powe NR, Laveist TA, Brant SR (2007) Race and health insurance are predictors of hospitalized Crohn’s disease patients undergoing bowel resection. Inflamm Bowel Dis 13:1408–1416PubMedCrossRef

Deveaux PG, Kimberling J, Galandiuk S (2005) Crohn’s disease: presentation and severity compared between black patients and white patients. Dis Colon Rectum 48:1404–1409PubMedCrossRef

Paul H Jr, Barnes RW, Reese VE et al (1990) Crohn’s disease in black patients. J Natl Med Assoc 82:709–712PubMedCentralPubMed

10.

Mahid SS, Mulhall AM, Gholson RD, Eichenberger MR, Galandiuk S (2008) Inflammatory bowel disease and African Americans: a systematic review. Inflamm Bowel Dis 14:960–967PubMedCrossRef

11.

Straus WL, Eisen GM, Sandler RS, Murray SC, Sessions JT (2000) Crohn’s disease: does race matter? The Mid-Atlantic Crohn’s Disease Study Group. Am J Gastroenterol 95:479–483PubMedCrossRef

12.

Wang MH, Okazaki T, Kugathasan S, et al (2012) Contribution of higher risk genes and European admixture to Crohn’s disease in African Americans.0 Inflamm Bowel Dis 18(12)2277-87

13.

Spivak W, Sockolow R, Rigas A (1995) The relationship between insurance class and severity of presentation of inflammator bowel disease in children. Am J Gastroenterol 90:982–987PubMed

14.

Smedley BD, Stith AY, Nelson R (2002) Unequal treatment: confronting racial and ethnic disparities in health care. National Academy Press, Washington, DC, pp 29–30

15.

Mayberry R, Mili F, Ofili E (2000) Racial and ethnic differences in access to health care. Med Care Res Rev 57:108–145PubMedCrossRef

16.

Simsek H, Schuman BM (1989) Inflammatory bowel disease in 64 black patients: analysis of course, complications, and surgery. J Clin Gastroenterol 11:294–298PubMedCrossRef

17.

Nguyen GC, LaVeist TA, Harris ML et al (2010) Racial disparities in utilization of specialist care and medications in inflammatory bowel disease. Am J Gastroenterol 105:2202–2208PubMedCentralPubMedCrossRef

18.

Jackson JF, Dhere T, Repaka A, Shaukat A, Sitaraman S (2008) Crohn’s disease in an African-American population. Am J Med Sci 336:389–392PubMedCrossRef

19.

Flasar MH, Johnson T, Roghmann MC, Cross RK (2008) Disparities in the use of immunomodulators and biologics for the treatment of inflammatory bowel disease: a retrospective cohort study. Inflamm Bowel Dis 14:13–19PubMedCrossRef

20.

Jackson JF, Kornbluth A (2007) Do black and Hispanic Americans with inflammatory bowel disease (IBD) receive inferior care compared with white Americans? Uneasy questions and speculations. Am J Gastroenterol 102:1343–1349PubMedCrossRef

21.

Joy GJ, Cross RK, Flasar MH (2009) Race and inflammatory bowel disease. Pract Gastroenterol 23–33

22.

Hou JK, El-Serag H, Thirumurthi S (2009) Distribution and manifestations of inflammatory bowel disease in Asians, Hispanics, and African Americans: a systematic review. Am J Gastroenterol 104:2100–2109PubMedCrossRef

23.

Sewell JL, Inadomi JM, Yee HF Jr (2010) Race and inflammatory bowel disease in an urban healthcare system. Dig Dis Sci 55:3479–3487PubMedCentralPubMedCrossRef

24.

Veluswamy H, Suryawala K, Sheth A et al (2010) African-American inflammatory bowel disease in a Southern U.S. health center. BMC Gastroenterol 10

25.

Goldman CD, Kodner IJ, Fry RD, McDermott RP (1986) Clinical and operative experience with non-Caucasian patients with CD. Dis Colon Rectum 29(5):317–321PubMedCrossRef

26.

Chow WH, Shuch B, Linehan WM, Devesa SS (2013) Racial disparity in renal cell carcinoma patient survival according to demographic and clinical characteristics. Cancer 119:388–394PubMedCentralPubMedCrossRef

27.

Farjah F, Wood DE, Yanez ND 3rd et al (2009) Racial disparities among patients with lung cancer who were recommended operative therapy. Arch Surg 144:14–18PubMedCentralPubMedCrossRef

28.

Causey MW, McVay D, Hatch Q et al (2013) The impact of race on outcomes following emergency surgery: an American College of Surgeons National Surgical Quality Improvement Program assessment. Am J Surg 206(2):172–179PubMedCrossRef

29.

Chu DI, Moreira DM, Gerber L et al (2012) Effect of race and socioeconomic status on surgical margins and biochemical outcomes in an equal-access health care setting: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Cancer 118:4999–5007PubMedCentralPubMedCrossRef

30.

Curry WT Jr, Carter BS, Barker FG 2nd (2010) Racial, ethnic, and socioeconomic disparities in patient outcomes after craniotomy for tumor in adult patients in the United States, 1988-2004. Neurosurgery 66:427–437, discussion 37-8PubMedCrossRef

31.

Scarborough JE, Bennett KM, Pappas TN (2012) Racial disparities in outcomes after appendectomy for acute appendicitis. Am J Surg 204:11–17PubMedCrossRef

32.

Nguyen GC, Patel AM (2013) Racial disparities in mortality in patients undergoing bariatric surgery in the USA. Obes Surg 23(10):1508–1514PubMedCrossRef

33.

Nathan H, Frederick W, Choti MA, Schulick RD, Pawlik TM (2008) Racial disparity in surgical mortality after major hepatectomy. J Am Coll Surg 207:312–319PubMedCrossRef

34.

Silber JH, Rosenbaum PR, Romano PS et al (2009) Hospital teaching intensity, patient race, and surgical outcomes. Arch Surg 144:113–120, discussion 21PubMedCentralPubMedCrossRef

35.

Haider AH, Scott VK, Rehman KA et al (2013) Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors. J Am Coll Surg 216(482–92):e12PubMed

Title: A comparison of abdominal surgical outcomes between African–American and Caucasian Crohn’s patients
Authors: Nicole Griglione
Shadi Yarandi
Jahnavi Srinivasan
Thomas Ahearn
Tanvi Dhere
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 8/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1902-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A comparison of abdominal surgical outcomes between African–American and Caucasian Crohn’s patients

Abstract

Background and objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and objective

Methods

Results

Conclusion

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