Racial and geographic disparities in reconstructive procedures following melanoma resection.

Abstract

Melanoma occurs most commonly in non-Hispanic White patients; however, Black and Hispanic patients experience greater morbidity and mortality. This study assesses how race and socioeconomic factors influence rates of reconstructive procedures and hospital-based outcomes in melanoma patients. Data were extracted from the National Inpatient Sample database from the years 2010-2015. Patients with melanoma who underwent a reconstructive procedure were identified. Univariate and multivariate logistic regression analysis was used to identify the relationship between dependent variables and various patient/hospital components for patients undergoing reconstructive procedures. Black and Hispanic patients had a greater length of stay (LOS) than non-Hispanic White patients (OR: 2.252, p=0.0307, and OR: 2.592, p=0.0014), and Hispanic patients were less likely to receive more complex reconstructive procedures (OR: 0.449, p=0.0487). Patients living in rural areas were less likely to receive complex reconstructive procedures than those in both urban teaching and non-teaching hospitals (OR: 3.313, p=0.0135, and OR: 3.505, p=0.0074). Pedicled or rotational flaps were less likely to be performed at medium- or large-sized hospitals (OR: 0.610, p=0.0296, and OR: 0.496, p=0.0002). Race and socioeconomic factors are important predictors of access to complex reconstructive procedures and hospital-based outcomes following extirpation in melanoma patients.