Thumbnail Image
Item

Examining the Hispanic Paradox in Post-Operative Complication Rates

Silviera, Matthew Leon
Citations
Altmetric:
Genre
Thesis/Dissertation
Date
2010
Advisor
Friedenberg, Frank K.
Committee member
Nelson, Deborah B.
Parkman, Henry P.
Group
Department
Clinical Research and Translational Medicine
Subject
Health Sciences, Medicine and Surgery
 Hispanic American Studies
 Ethnicity
 Hispanic Paradox
 Post-operative Complications
 Race
Permanent link to this record
http://hdl.handle.net/20.500.12613/2391
Collections
Theses and Dissertations
Show all metadata
Files
Thumbnail Image
Silviera_temple_0225M_10395.pdf
Adobe PDF, 117.17 KB
Research Projects
Organizational Units
Journal Issue
DOI
http://dx.doi.org/10.34944/dspace/2373
Abstract
INTRODUCTION: Racial disparities exist in both healthcare access and outcomes. Despite high poverty rates, less education, and worse access to healthcare, the Hispanic population as a whole experiences equal, if not better outcomes compared to their non- Hispanic White counterparts. We sought to determine if race was significantly associated with the development of serious post-operative complications (POC) among patients undergoing intra-abdominal general surgical procedures. METHODS: We performed a retrospective cohort study of patients undergoing appendectomy, cholecystectomy, or colectomy at a single healthcare system over a 12 month period. Medical records were reviewed for patient demographics, co-morbidities, operative variables, and the occurrence of selected post-operative complications. Variables found to be significantly associated with the development of a POC on univariate analysis were entered into a multivariate logistic regression model to determine the effect of Hispanic race on POC. Additionally, we constructed a propensity score adjusted logistic regression model as a confirmation of our findings. RESULTS: Among 456 patients, 48 (10.5%) developed a POC. Hispanic race, age, tobacco use, selected co-morbidities, surgical procedure and surgical approach were all associated with POC on univariate analysis. On multivariate logistic regression analysis, after adjusting for confounders, Hispanic race, age, tobacco use, and surgical approach were all significantly associated with POC. Hispanic race was the strongest independent predictor, and was found to be protective against the development of a POC (adjusted OR= 0.22, p-value=0.048). The propensity score adjusted regression model provided a similar estimate of the effect of Hispanic race on POC (adjusted OR= 0.20, p-value=0.03). CONCLUSIONS: We have demonstrated that Hispanic patients undergoing common intra-abdominal surgical procedures have lower rates of serious post-operative complications, even after adjusting for patient demographics, co-morbidities, and operative variables. This, and other existing data, suggests that Hispanic patients may incur some type of overall health advantage despite the socioeconomic hardships they often face.
Description
Citation
Citation to related work
Has part
ADA compliance
For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu
Embedded videos