Older minorities face higher risk of postop complications

Older black and Hispanic patients have a greater risk than white patients of developing complications following surgery, according to a study.

Research has shown that minority groups tend to develop complications following surgery more often than whites, according to background information in the study, which was published in the September issue of the Journal of the American Geriatrics Society. Investigators at the University of Pennsylvania School of Nursing examined 13 frequent complications among 587,314 white, black and Hispanic patients ages 65 and older who underwent general, orthopedic or vascular surgery in 600 hospitals.

The researchers discovered that black and Hispanic patients have a greater chance than white patients of developing a vast majority of postoperative complications. Black patients were nearly three times more likely than white patients to develop 12 of the 13 complications identified by researchers. Hispanic patients were twice as likely as white patients to develop nine of the 13 complications, but less likely than white patients to develop two of the complications.

When hospital and patient characteristics were taken into account, the number of complications experienced more by black and Hispanic patients significantly dropped.

“The risk of developing a postoperative complication may be attributed to a number of factors,” J. Margo Brooks Carthon, RN, PhD, the study’s lead author, said in a news release. “Most pronounced, however, was the effect of preexisting medical conditions.”

The investigators also found the racial disparities that persisted after accounting for hospital and patient characteristics were different for male and female patients.

“Older black and Hispanic patients admitted to hospitals for common surgeries have a disproportionately higher risk of developing complications,” Brooks Carthon said. “The risk of developing certain post-surgical complications, however, differs for men and women — even men and women of the same ethnic and racial backgrounds.”

The findings demonstrate the need to improve surgical safety and quality, particularly for older minority patients who often are sicker going into surgery and thereby at greater risk for complications. “Our study also suggests the need for further evaluation of patient risk factors prior to surgery and more vigilant surveillance of patients following operative procedures,” Brooks Carthon said.

Study abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.12419/abstract

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