Impact of hospital teaching status on outcomes of colorectal cancer in hispanic patients: A nationwide analysis.

Abstract

e15520 Background: Previous studies described lower mortality in teaching hospitals after colorectal surgery. Hispanics represent a growing minority in the USA. Given their scarcity of representation in clinical studies, it is imperative to study the impact of teaching status on hospital outcomes from colorectal cancer (CRC) in the Hispanic population. Methods: We investigated the National Inpatient Sample 2017-2019 using International Classification of Diseases-10 (ICD-10) codes to include adult Hispanics with CRC. Mortality, morbidity, resource utilization, and surgical outcomes were compared stratified by hospital teaching status. Analyses were performed using STATA (v 14.2), considering 2 sided P< 0.05 as statistically significant. Proportions were compared using Fisher exact test and continuous variables using Student's t-test. Confounding variables were adjusted using multivariate logistic and linear regression analyses. Results: Out of 72,599 included patients, 15,895 were treated at non-teaching and 56,704 at teaching hospitals. Patients treated at teaching hospitals had 21% lower odds of inpatient mortality (Adjusted odds ratio (aOR) for mortality 0.79, 95% confidence interval (CI): 0.64 – 0.97, P= 0.03). There were no differences between markers of resource utilization (length of stay, hospital charges, and ICU admission). Patients at teaching hospitals had higher odds of acute renal failure (aOR 1.15, 95% CI: 1.02 – 1.30, P= 0.02). Rates of acute respiratory failure, lower GI bleeding, and sepsis were comparable between the two groups. Colectomy and procedure-related complication rates (including intubation, post-operative DVT/PE) were equal between the two studied groups except for post-operative adhesions, which were higher at teaching hospitals (aOR 1.29, 95% CI: 1.05 – 1.58, P= 0.01). Conclusions: There appears to be no difference in colectomy rates in teaching or non-teaching hospitals, which results in comparable in-hospital mortality in Hispanics. However, ARF and post-operative adhesions were more in teaching hospitals. Continued efforts are required to provide better access to healthcare and address morbidity disparities while caring for minorities.[Table: see text]