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Objective <p>Previously, African American race/ethnicity predisposed to higher rate of adverse in-hospital outcomes after radical cystectomy (RC). We tested whether this association applies to contemporary RC patients.</p> Methods <p>Patients were identified within the National Inpatient Sample (NIS 2000–2019). Multivariable logistic and Poisson regression models were fitted.</p> Results <p>Of 19,370 RC patients, 1,089 (5.6%) were African American, while 18,281 (94.4%) were Caucasian. Relative to Caucasians, African Americans were younger (median age 66 vs. 70&#xa0;years; <i>p</i> &lt; 0.001), more frequently female (33.8 vs. 18.5%; <i>p</i> &lt; 0.001) and more frequently in the lowest income quartile (46.8 vs. 18.6%; <i>p</i> &lt; 0.001). Relative to Caucasians, after RC, African Americans exhibited higher rates of postoperative complications (61.3 vs. 58.3%; multivariable odds ratio [MOR] 1.2; <i>p</i> = 0.009). Specifically, African Americans exhibited higher rates of blood transfusions (30.2 vs. 24.1%; MOR 1.3; <i>p</i> &lt; 0.001), gastrointestinal (26.7 vs. 24.1%; MOR 1.2; <i>p</i> = 0.003), and infectious (6.2 vs. 4.2%; MOR 1.5; <i>p</i> = 0.001) complications, as well as deep vein thrombosis (3.1 vs. 1.7%; MOR 1.9; <i>p</i> &lt; 0.001). Additionally, after RC, African Americans exhibited higher rates of critical care therapy use (CCT; 13.9 vs. 12.2%; MOR 1.3; <i>p</i> = 0.002) and in-hospital mortality (2.8 vs. 1.7%; MOR 1.8; <i>p</i> = 0.002). Finally, African Americans exhibited higher rates of length of stay ≥ 75th percentile (40.9 vs. 31.2%; MOR 1.6; <i>p</i> &lt; 0.001).</p> Conclusions <p>In contemporary RC patients, African American race/ethnicity predisposes to less favorable in-hospital outcomes, including higher in-hospital mortality and longer hospital stay. Unfortunately, these race/ethnicity disadvantages have not been improved upon relative to the previous report.</p>

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Effect of Race/Ethnicity on In-hospital Outcomes After Radical Cystectomy

  • 期刊论文

  • 发表日期：

    2025年3月4日

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  • Natali Rodriguez Peñaranda,
  • Francesco Di Bello,
  • Fabian Falkenbach,
  • Andrea Marmiroli,
  • Mattia Longoni,
  • Quynh Chi Le,
  • Jordan A. Goyal,
  • Zhe Tian,
  • Fred Saad,
  • Shahrokh F. Shariat,
  • Nicola Longo,
  • Markus Graefen,
  • Ottavio De Cobelli,
  • Alberto Briganti,
  • Felix K. H. Chun,
  • Stefano Di Bari,
  • Giuseppe Stella,
  • Stefano Puliatti,
  • Salvatore Micali,
  • Pierre I. Karakiewicz

摘要

Objective

Previously, African American race/ethnicity predisposed to higher rate of adverse in-hospital outcomes after radical cystectomy (RC). We tested whether this association applies to contemporary RC patients.

Methods

Patients were identified within the National Inpatient Sample (NIS 2000–2019). Multivariable logistic and Poisson regression models were fitted.

Results

Of 19,370 RC patients, 1,089 (5.6%) were African American, while 18,281 (94.4%) were Caucasian. Relative to Caucasians, African Americans were younger (median age 66 vs. 70 years; p < 0.001), more frequently female (33.8 vs. 18.5%; p < 0.001) and more frequently in the lowest income quartile (46.8 vs. 18.6%; p < 0.001). Relative to Caucasians, after RC, African Americans exhibited higher rates of postoperative complications (61.3 vs. 58.3%; multivariable odds ratio [MOR] 1.2; p = 0.009). Specifically, African Americans exhibited higher rates of blood transfusions (30.2 vs. 24.1%; MOR 1.3; p < 0.001), gastrointestinal (26.7 vs. 24.1%; MOR 1.2; p = 0.003), and infectious (6.2 vs. 4.2%; MOR 1.5; p = 0.001) complications, as well as deep vein thrombosis (3.1 vs. 1.7%; MOR 1.9; p < 0.001). Additionally, after RC, African Americans exhibited higher rates of critical care therapy use (CCT; 13.9 vs. 12.2%; MOR 1.3; p = 0.002) and in-hospital mortality (2.8 vs. 1.7%; MOR 1.8; p = 0.002). Finally, African Americans exhibited higher rates of length of stay ≥ 75th percentile (40.9 vs. 31.2%; MOR 1.6; p < 0.001).

Conclusions

In contemporary RC patients, African American race/ethnicity predisposes to less favorable in-hospital outcomes, including higher in-hospital mortality and longer hospital stay. Unfortunately, these race/ethnicity disadvantages have not been improved upon relative to the previous report.