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01-02-2018 | 2017 SSAT Plenary Presentation

Racial Disparities After Stoma Construction Exist in Time to Closure After 1 Year but Not in Overall Stoma Reversal Rates

Authors: Drew J. Gunnells Jr., Lauren N. Wood, Lauren Goss, Melanie S. Morris, Gregory D. Kennedy, Jamie A. Cannon, Daniel I. Chu

Published in: Journal of Gastrointestinal Surgery | Issue 2/2018

Abstract

Introduction

Conflicting data exist on racial disparities in stoma reversal (SR) rates. Our aim was to investigate the role of race in SR rates, and time to closure, in a longitudinal, racially diverse database.

Methods

All adult patients (>18 years) who received an ileostomy or colostomy from 1999 to 2016 at a single institution were identified. Primary outcomes were SR rates and time to closure. Failure to reverse and time to closure was modeled using Cox regression. Kaplan-Meier survival curves, stratified by race, were generated for time to closure and hazard ratios (HRs) calculated.

Results

Of 770 patients with stomas, 65.6% of patients underwent SR; 76.6% were white and 23.4% were black. On adjusted analysis, race did not predict overall SR rates or time to closure if performed less than 1 year. Instead, significant predictors for failure in SR included age, insurance status, end colostomy/ileostomy, and loop colostomy (p < 0.05). Predictors of delay in time to closure included insurance, end colostomy/ileostomy, and loop colostomy (p < 0.05). In patients who underwent reversal after 1 year, black race was an independent predictor of time to closure (HR 0.21, 95% CI 0.07–0.63, p < 0.05).

Conclusion

SR rates were equal between black and white patients. Disparities in time to closure existed only for black patients if reversed more than 1 year after index stoma construction. While equitable outcomes were achieved for most patients, further investigation is necessary to understand stoma disparities after 1 year.

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Title: Racial Disparities After Stoma Construction Exist in Time to Closure After 1 Year but Not in Overall Stoma Reversal Rates
Authors: Drew J. Gunnells Jr.
Lauren N. Wood
Lauren Goss
Melanie S. Morris
Gregory D. Kennedy
Jamie A. Cannon
Daniel I. Chu
Publication date: 01-02-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3514-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Racial Disparities After Stoma Construction Exist in Time to Closure After 1 Year but Not in Overall Stoma Reversal Rates

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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