Race/ethnicity and socio-economic differences in breast cancer surgery outcomes
Race/ethnicity and socio-economic differences in breast cancer surgery outcomes
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DOI：
10.1016/j.canep.2015.07.010
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发表时间：
2015-10-01
影响因子：
2.6
通讯作者：
Budhwani, Henna
中科院分区：
文献类型：
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作者：
Akinyemiju, Tomi F.;Vin-Raviv, Neomi;Budhwani, Henna
背景资料：本研究的目的是评估住院乳腺癌患者在乳腺癌手术治疗、术后并发症、住院时间和死亡率方面的种族和社会经济差异。我们检查了71名患者的种族/民族和社会经济地位与治疗和术后结局之间的关系，使用2007年至2011年的全国住院患者样本数据库，对156名主要诊断为乳腺癌的住院女性进行了研究。多变量回归模型被用来计算估计，比值比和95%的置信区间调整年龄，合并症，在诊断阶段，保险，和住宅region.Results：黑人妇女更有可能接受保乳手术，但不太可能接受乳房切除术相比，白色妇女。他们的住院时间也明显延长（β = 0.31，95% CI：0.24，0.39），术后并发症（OR = 1.21，95%CI：1.04-1.42）和住院死亡率（OR = 1.26，95%CI：1.07-1.50）与白人相比，在调整其他因素后，包括合并症的数量和治疗类型。在因乳腺癌住院的患者中，观察到治疗和结局存在种族差异。需要进一步的研究来充分表征这些差异是否是由于个人，提供者水平或医院水平的因素，并强调有针对性的方法来消除这些差异的领域。(C)2015爱思唯尔有限公司版权所有。
Background: The purpose of this study is to evaluate racial and socio-economic differences in breast cancer surgery treatment, post-surgical complications, hospital length of stay and mortality among hospitalized breast cancer patients.Methods: We examined the association between race/ethnicity and socio-economic status with treatment and outcomes after surgery among 71,156 women hospitalized with a primary diagnosis of breast cancer using the Nationwide Inpatient Sample database from 2007 to 2011. Multivariable regression models were used to compute estimates, odds ratios and 95% confidence intervals adjusting for age, comorbidities, stage at diagnosis, insurance, and residential region.Results: Black women were more likely to receive breast conserving surgery but less likely to receive mastectomies compared with white women. They also experienced significantly longer hospital stays (beta = 0.31, 95% CI: 0.24, 0.39), post-surgical complications (OR = 1.21, 95% CI: 1.04-1.42) and in-hospital mortality (OR = 1.26, 95% CI: 1.07-1.50) compared with Whites, after adjusting for other factors including the number of comorbidities and treatment type.Conclusion: Among patients hospitalized for breast cancer, there were racial differences observed in treatment and outcomes. Further studies are needed to fully characterize whether these differences are due to individual, provider level or hospital level factors, and to highlight areas for targeted approaches to eliminate these disparities. (C) 2015 Elsevier Ltd. All rights reserved.