Postoperative complications and survivorship trends following ovarian cancer surgery in New York state

2017 ◽  
Vol 145 ◽  
pp. 168
Author(s):  
Z. Xu ◽  
A.Z. Becerra ◽  
F.J. Fleming ◽  
F.P. Boscoe ◽  
M.J. Schymura ◽  
...  
2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6640-6640
Author(s):  
Umut Sarpel ◽  
Natalia Egorova ◽  
Eugene Sosunov ◽  
Rebeca Franco ◽  
Yohana Taveras ◽  
...  

6640 Background: 30-day readmission rates are currently being used as a measure of performance quality. Among surgical patients, readmissions may be reducible for certain complications such as deep venous thrombosis or wound infection. We report 30-day readmission rates for potentially preventable readmissions following surgical treatment of the most common malignancies in the US. Methods: The most common cancer hospitalizations were identified from the Healthcare Cost and Utilization Project. Previously reported ICD-9 codes of preventable readmissions from cancer surgery were used to assess 30-day readmissions in New York State in 2009. We measured comorbidity using CMS hierarchical condition categories. Hospital teaching status was based on the American Hospital Association designation. Random effect hierarchical logistic regression models were run to account for clustering within hospitals. Results: 21,945 index admissions for cancer surgery occurred in 2009 at 169 teaching and 73 non-teaching hospitals. The most common operations were for prostate, breast, colon, lung, and renal cancer. 51% of patients were male and 12% were black. The overall readmission rate was 9.3% with readmissions being higher in non-teaching hospitals (11.2%) vs. teaching hospitals (8.6%) (p<0.0001). There was a significant interaction between hospital teaching status and patient race. In teaching hospitals, there was no racial difference in readmission. However, in non-teaching hospitals, black patients were more likely to be readmitted (15.1% vs 10.9%; p=0.02). Multivariate models found that being male (OR=1.17; 95% CI: 1.04; 1.31; p=0.007), undergoing surgery at a non-teaching hospital (OR=1.16; 95% CI: 1.00; 1.35; p=0.048), black race (OR=1.47; 95% CI: 1.04; 2.08; p=0.029), and certain comorbidities increased a patient’s risk of 30-day readmission for a preventable cause. Conclusions: The 30-day preventable readmission rate after index hospitalizations for cancer surgery is higher in non-teaching hospitals, and this difference is more pronounced for black patients. Clinical protocols in teaching hospitals may play a role in this phenomenon. Efforts to address remediable causes of this disparity are warranted.


2022 ◽  
Vol 273 ◽  
pp. 64-70
Author(s):  
Maaike van Gerwen ◽  
Mathilda Alsen ◽  
Naomi Alpert ◽  
Catherine Sinclair ◽  
Emanuela Taioli

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5579-5579
Author(s):  
Sarah Madhu Temkin ◽  
Zhaomin Xu ◽  
Carla Francesca Justiniano ◽  
Adan Z Becerra ◽  
Christopher Thomas Aquina ◽  
...  

5579 Background: Disparities between black and white patients are well documented in gynecologic cancers but information on the contributions of social factors and medical comorbidities is sparse. We examined differences in outcomes amongst black and white women with ovarian cancer in New York State. Methods: Patients with incident ovarian cancer in the New York State Cancer Registry and the Statewide Planning and Research Cooperative System from 2006-2013 were included. Differences in social and demographic factors, comorbidities and tumor characteristics between black and white women were examined with bivariate analysis. Multivariable analyses were used to examine factors associated with specific treatments and survival. Results: Of 5969 patients, 87% were white and 13% black. Age, Hispanic ethnicity and median income were similar between groups. Black women were less likely to be married (27 vs 48%, p < 0.01); and less likely to be privately insured (20 vs 50%, p < 0.01). More black women had comorbidities by Charlson Comorbidity Index (CCI) (63 vs 51%, p < 0.01). Black women were more likely to have Stage IV disease and non-serous histology (p < 0.01). More black women were treated at academic medical centers (67 vs 50%, p < 0.01). Marital status, insurance, CCI, stage, histology and treatment site correlated to the type of treatment received (p < 0.01). Black women received different treatment and had higher odds of receiving no treatment 1.63 (1.24, 2.14); chemotherapy without surgery 1.26 (1.00, 1.59); lower odds of undergoing primary surgical management 0.71 (0.58, 0.86) or chemotherapy following surgery 0.79 (0.66, 0.96; and similar rates of neoadjuvant chemotherapy. The risk of 5 year mortality was 1.14 (1.02, 1.27) times higher for black women compared with whites. Marital status, CCI, stage and histology correlated with overall and disease specific survival among both black and white women (p < 0.01). Conclusions: Multiple factors, including race, are associated with receipt of treatment and survival in ovarian cancer. Treatment for ovarian cancer was significantly different amongst black women than white in New York State. Understanding modifiable influences on racial disparities is imperative to reducing race based differences in outcomes.


2017 ◽  
Vol 145 ◽  
pp. 63
Author(s):  
J. Parker ◽  
N. Crnosija ◽  
A. Plair ◽  
T. Griffin ◽  
M.S. Henretta

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