Racial Disparities in Total Abdominal Hysterectomy Postoperative Outcomes: Analysis Including American Indian or Alaska Natives and Native Hawaiian or Pacific Islanders [ID: 1377744

Abstract

INTRODUCTION: Racial disparities in total abdominal hysterectomy outcomes among individuals in Black and Hispanic populations are well described in the literature. However, disparities in such outcomes for American Indians or Alaskan Natives (AI/AN) and Native Hawaiians or Pacific Islanders (NH/PI) remain understudied. Thus, the aim of our study is to assess total abdominal hysterectomy outcomes in Black, Hispanic, Asian, AI/AN, and NH/PI populations. METHODS: The National Surgical Quality Improvement Program was queried to identify all total abdominal hysterectomy procedures in the 2011 to 2020 National Surgical Quality Improvement Project (n=81,655). Multivariable regression models were used to investigate the effect of race and ethnicity on 30-day postoperative complications, readmission, and mortality. RESULTS: Compared to non-Hispanic White patients, Black patients had 0.7% higher odds of readmission (adjusted odds ratio [AOR] 1.007, 95% CI 1.003–1.011) and 2.3% higher odds of postoperative complications (AOR 1.023, 95% CI 1.016–1.030). Hispanic patients had 1.3% higher odds of a postoperative complication (AOR 1.013, 95% CI 1.004–1.021). AI/AN patients had 5.6% higher odds of a postoperative complication (AOR 1.056, 95% CI 1.020–1.093). NH/PI patients had the highest odds of a postoperative complication, 9.1% higher odds compared to non-Hispanic White patients (AOR 1.091, 95% CI 1.056–1.126), and were the only minority group associated with higher odds of mortality (AOR 1.007, 95% CI 1.004–1.010). CONCLUSION: AI/AN and NH/PI, which have been underrepresented in past research, experienced the highest rates of postoperative complications in total abdominal hysterectomy, highlighting the importance of including these patients in the discussion of policy and hysterectomy research studies.