Racial Disparities in Vaginal Hysterectomy Postoperative Outcomes: Trends Using the NSQIP Database [ID: 1377940

Abstract

INTRODUCTION: Vaginal hysterectomies (VHs) are associated with superior outcomes in operative time, postoperative complications (PCs), and recovery, and thus VH is often the preferred approach whenever feasible. Racial disparities have previously been described for abdominal and laparoscopic hysterectomies, but not for the vaginal approach. The purpose of this study was to disaggregate racial data and evaluate variation in VH surgical outcomes by race. METHODS: The National Surgical Quality Improvement Program was queried to identify all VHs from 2011 to 2020 in the National Surgical Quality Improvement Project (n=59,469). Multivariable regression models were used to investigate the effect of race on 30-day PCs and same-day discharge (SDD). RESULTS: Compared to non-Hispanic White patients and other minority groups, American Indians and Alaskan Natives (AI/AN) had 2.6% higher odds of PC (adjusted odds ratio [AOR] 1.026, 95% CI 1.002–1.050) and 6.2% lower odds of SDD (AOR 0.938, 95% CI 0.911–0.965). Non-Hispanic Black patients had 1.1% higher odds of PC (AOR 1.011, 95% CI 1.003–1.020). Paradoxically, Native Hawaiian and Pacific Islander (NH/PI), Asian, and Hispanic patients had 30.9%, 18.7%, and 3.3% higher odds of SDD, respectively, without statistically significant increased odds of PC. CONCLUSION: AI/AN and Black patients were more likely to have a PC, while NH/PI, Asian, and Hispanic patients were more likely to have SDD without significantly higher odds of PC. Given these findings, it may be reasonable to encourage the VH approach especially in the NH/PI, Asian, and Hispanic patient populations.