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Akinyemi OA, Weldeslase TA, Andine TF, Fasokun M, Griffiths Y, Odusanya E, Williams M, Hughes K, Cornwell E, Fullum T. Race, Insurance, and Socioeconomic Influences on Outcomes Following Roux-En-Y Gastric Bypass. Am Surg 2024:31348241248803. [PMID: 38647079 DOI: 10.1177/00031348241248803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The effectiveness of Roux-en-Y gastric bypass (RYGB) might be shadowed by disparities in outcomes related to patient race and insurance type. We determine the influence of patient race/ethnicity and insurance types on complications following RYGB. We performed a retrospective analysis using data sourced from the National Inpatient Sample Database (2010 to 2019). A multivariate analysis was employed to determine the relationship between patient race/ethnicity and insurance type on RYGB complications. The analysis determined the interaction between race/ethnicity and insurance type on RYGB outcomes. We analyzed 277714 patients who underwent RYGB. Most of these patients were White (64.5%) and female (77.3%), with a median age of 46 years (IQR 36-55). Medicaid beneficiaries displayed less favorable outcomes than those under private insurance: Extended hospital stay (OR = 1.68; 95% CI 1.58-1.78), GIT Leak (OR = 1.83; 95% CI 1.35-2.47), postoperative wound infection (OR = 1.88; 95% CI 1.38-2.55), and in-hospital mortality (OR = 2.74; 95% CI 1.90-3.95).
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Affiliation(s)
- Oluwasegun A Akinyemi
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Terhas A Weldeslase
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Tsion F Andine
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Mojisola Fasokun
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yasmine Griffiths
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Eunice Odusanya
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Mallory Williams
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Kakra Hughes
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Edward Cornwell
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Terrence Fullum
- Department of Surgery, Howard University Hospital, Washington, DC, USA
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Akinyemi O, Abodunrin F, Andine TF, Akinwumi B, Akinyemi I, Ojo A, Lipscombe C, Silberstein PT. Profile and outcomes of patients with subsequent ovarian cancer diagnosis following a prior malignancy in the United States. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18541 Background: The relationship between a subsequent ovarian cancer and a prior malignancy is complex with possible etiological, genetic, and therapeutic implications. Little is known about the epidemiological and clinical profile of this category of patients. The aim of the present study is to determine the factors associated with the development of ovarian cancer as a subsequent malignancy after a prior malignancy from another organ and determinants of improved survival in these women. Methods: We utilized the SEER 18 Registry 1975-2016 to conduct a retrospective analysis of women who developed a second primary ovarian malignancy following a prior cancer diagnosis. The outcome of interest was the latency interval between the initial primary malignancy diagnosis and a subsequent ovarian cancer diagnosis. Utilizing the cox regression model, we determined the factors associated with the overall survival of these women. Results: There were 10, 800 women who subsequently developed ovarian cancers following a prior malignancy. The commonest prior malignancies were breast cancers (38.2%), endometrial cancers (23.7%), and colorectal cancers (9.5%). The latency interval from developing a subsequent ovarian malignancy was 6.8±6.3 yrs. (Breast cancers) and 0.6 ± 2.5 yrs. (Endometrial cancers). A prior surgical treatment (OR = 1.19; 95% CI 1.02-1.40) or radiotherapy (OR = 1.34, 95% CI 1.21-1.49) in the initial primary malignancy is associated with a > 5years development of a subsequent ovarian malignancy. Black patients (OR = 1.63, 95% CI 1.39-1.92) have the worst survival even after controlling for disease stage and treatment modalities. Determinants of improved overall survival include White race, private insurance, age < 45 years at first primary malignancy diagnosis, prior surgical therapy, and increased latency interval. A prolonged latency interval is associated with a 74% increase in survival (OR = 0.26; 95%CI 0.23-0.30). Conclusions: Determinants of improved survival among patients with subsequent ovarian cancers following a prior primary malignancy include White race, private insurance, and a prolonged latency interval of progression from an initial primary malignancy to a subsequent ovarian cancer.
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Affiliation(s)
| | - Faith Abodunrin
- Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE
| | | | | | | | - Ademola Ojo
- Department of Internal Medicine, Howard University School of Medicine, Macomb, IL
| | - Christina Lipscombe
- Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC
| | - Peter T. Silberstein
- Department of Hematology and Oncology, Creighton University School of Medicine, Omaha, NE
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