Comparing outcomes of cholecystectomies in white vs. minority patients

1. For patients with gallbladder disease requiring cholecystectomy, no differences in clinical outcomes were found between white and non-white minority patients.

Evidence Rating Level: 2 (Good)

Cholecystectomies are common procedures for patients presenting with gall stones or other gallbladder disease. For individuals who lack insurance, are from minority groups, or are of lower socioeconomic status (SES), there may be increased barriers to accessing care. Delayed access to care can lead to more severe gallbladder disease on presentation, perioperative complications, and may require an open procedure instead of a laparoscopic one. Therefore, the current retrospective study aimed to elucidate the differences between white and minority individuals with gallbladder disease requiring cholecystectomy, with regards to morbidity, mortality, and cost of hospital admission. The study population consisted of 1539 patients undergoing cholecystectomies at a single centre between 2013 and 2018, 36.9% of whom were white and 63.1% of whom were non-white minorities. The results showed that the likelihood of an emergent admission was greater in minority than white patients (76.2% vs 68.4%), and that the mean age was younger in minorities than white (45.5 vs 53.9 years, p < 0.01). However, minority patients had a greater likelihood of a laparoscopic procedure (88.7% vs 79.0%). As well, there were no differences between minorities and whites in length of hospital stay (4.8 vs 4.4 days, p = 0.42), no significant difference in the percentage of minority vs white patients admitted to the ICU (3.4% vs 5.3%), and no differences in intraoperative or postop complications (p = 0.07). With regards to cost, more minority patients were uninsured (32.1% vs 6.5%), and the charge for uninsured patients was lower than Medicare by 39.3 per 1000 dollars (p < 0.001). Overall, this study demonstrated that while the presentation of minorities with gallbladder disease is younger and more emergent, the clinical outcomes are the same.

Click to read the study in American Journal of Surgery

Image: PD

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