Asian Americans have higher 30-day surgical complications after esophagectomy: A propensity-score matched study from ACS-NSQIP database

Abstract

BackgroundDespite Asian Americans having a heightened risk profile for esophageal cancer, racial disparities within this group have not been investigated. This study seeks to evaluate the 30-day postoperative outcomes for Asian Americans following esophagectomy. MethodsA retrospective analysis was performed using ACS-NSQIP esophagectomy targeted database 2016–2021. A 1:3 propensity-score matching was applied to Asian Americans and Caucasians who underwent esophagectomy to compare their 30-day outcomes. ResultsThere were 229 Asian Americans and 5303 Caucasians identified. Asian Americans were more likely to have squamous cell carcinoma than adenocarcinoma. After matching, 687 Caucasians were included. Asian Americans had higher pulmonary complications (22.27 ​% vs 16.01 ​%, p ​= ​0.04) especially pneumonia (16.59 ​% vs 11.06 ​%, p ​= ​0.04), renal dysfunction (2.62 ​% vs 0.44 ​%, p ​= ​0.01) especially progressive renal insufficiency (1.31 ​% vs 0.15 ​%, p ​< ​0.05), and bleeding events (18.34 ​% vs 9.02 ​%, p ​< ​0.01). In addition, Asian Americans had longer LOS (11.83 ​± ​9.39 vs 10.23 ​± ​7.34 days, p ​= ​0.03). ConclusionAsian Americans were found to face higher 30-day surgical complications following esophagectomy. Continued investigation into the underlying causes and potential mitigation strategies for these disparities are needed.