Loading…
Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery
Introduction and hypothesis There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to a...
Saved in:
| Published in: | International Urogynecology Journal 2024, Vol.35 (1), p.35-42 |
|---|---|
| Main Authors: | , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c326t-562106852526638cd91dd9147549ba0b4f9b0de585c0d13266a17dece6c714853 |
| container_end_page | 42 |
| container_issue | 1 |
| container_start_page | 35 |
| container_title | International Urogynecology Journal |
| container_volume | 35 |
| creator | Margulies, Samantha L. Sakai, Nozomi Geller, Elizabeth J. |
| description | Introduction and hypothesis
There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of patients undergoing SUI surgery from 2010 to 2019. Chi-squared or Fisher’s exact test and ANOVA were used for categorical and continuous variables respectively. Breslow day score and multinomial and multiple logistic regression models were used.
Results
A total of 53,333 patients were analyzed. Using White race/ethnicity and sling surgery as references, Hispanic patients underwent more laparoscopic surgeries (OR1.17 [CI 1.03, 1.33]) and anterior vesico-urethropexy/urethropexies (OR 1.97 [CI 1.66, 2.34]); Black patients underwent more anterior vesico-urethropexy/urethropexies (OR 1.49 [CI 1.07, 2.07]), abdomino-vaginal vesical neck suspensions (OR 2.19 [CI 1.05–4.55]), and inflatable urethral slings (OR 4.28 [CI 1.23–14.90]). White patients had lower rates of inpatient stay (
p
|
| doi_str_mv | 10.1007/s00192-023-05583-5 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2832576029</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2918364719</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-562106852526638cd91dd9147549ba0b4f9b0de585c0d13266a17dece6c714853</originalsourceid><addsrcrecordid>eNp9kc1OxCAUhYnROOPoC7gwJG7cVC9QaLs0xr9kEhOja0IpVSYztAJdzNtL7aiJCxeEBL5z4J6D0CmBSwJQXAUAUtEMKMuA85JlfA_NSc5YxtLZPppDxYqM5YLO0FEIKwDIgcMhmrGCVZRSPkfqWWmr1li5Bpv47qzGjQ298jZusXXYqWg7l4DeKx2tNrhXMRrvAm47j0P0JgQ8eOuUHwW6c9E64xIYBv9m_PYYHbRqHczJbl-g17vbl5uHbPl0_3hzvcw0oyJmXFACouSUUyFYqZuKNGnlBc-rWkGdt1UNjeEl19CQJBGKFI3RRuiC5CVnC3Qx-fa--xhMiHJjgzbrtXKmG4KkJaO8EECrhJ7_QVfd4NOUiapIyURekJGiE6V9F4I3rey93aQxJQE5FiCnAmQKW34VIMdfnO2sh3pjmh_Jd-IJYBMQ0pVLAf2-_Y_tJ2BTkII</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2918364719</pqid></control><display><type>article</type><title>Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery</title><source>Springer Link</source><creator>Margulies, Samantha L. ; Sakai, Nozomi ; Geller, Elizabeth J.</creator><creatorcontrib>Margulies, Samantha L. ; Sakai, Nozomi ; Geller, Elizabeth J.</creatorcontrib><description>Introduction and hypothesis
There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of patients undergoing SUI surgery from 2010 to 2019. Chi-squared or Fisher’s exact test and ANOVA were used for categorical and continuous variables respectively. Breslow day score and multinomial and multiple logistic regression models were used.
Results
A total of 53,333 patients were analyzed. Using White race/ethnicity and sling surgery as references, Hispanic patients underwent more laparoscopic surgeries (OR1.17 [CI 1.03, 1.33]) and anterior vesico-urethropexy/urethropexies (OR 1.97 [CI 1.66, 2.34]); Black patients underwent more anterior vesico-urethropexy/urethropexies (OR 1.49 [CI 1.07, 2.07]), abdomino-vaginal vesical neck suspensions (OR 2.19 [CI 1.05–4.55]), and inflatable urethral slings (OR 4.28 [CI 1.23–14.90]). White patients had lower rates of inpatient stay (
p
< 0.0001) and blood transfusion (
p
< 0.0001) compared with patients who were Black, indigenous, people of color (BIPOC). Over time, Hispanic and Black patients were more likely to undergo anterior vesico-urethropexy/urethropexies than White patients (RR 2.03:1 [CI 1.72–2.40]) and (RR 1.59 CI [1.15–2.20]) respectively. Adjusting for possible confounders, Hispanic and Black patients had a greater chance of having a nonsling surgery, 37% (
p
< 0.0001) and 44% (
p
= 0.0001) greater chances respectively.
Conclusion
We observed racial/ethnic differences in SUI surgeries. Although causality cannot be proven here, our results confirm previous findings suggesting inequities in care.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-023-05583-5</identifier><identifier>PMID: 37392225</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Cultural differences ; Ethnicity ; Gynecology ; Hispanic people ; Humans ; Medicine ; Medicine & Public Health ; Original Article ; Race ; Retrospective Studies ; Suburethral Slings ; Surgery ; Urinary Bladder ; Urinary incontinence ; Urinary Incontinence, Stress - surgery ; Urologic Surgical Procedures - methods ; Urology</subject><ispartof>International Urogynecology Journal, 2024, Vol.35 (1), p.35-42</ispartof><rights>The International Urogynecological Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The International Urogynecological Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-562106852526638cd91dd9147549ba0b4f9b0de585c0d13266a17dece6c714853</cites><orcidid>0000-0002-5731-3740</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37392225$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Margulies, Samantha L.</creatorcontrib><creatorcontrib>Sakai, Nozomi</creatorcontrib><creatorcontrib>Geller, Elizabeth J.</creatorcontrib><title>Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of patients undergoing SUI surgery from 2010 to 2019. Chi-squared or Fisher’s exact test and ANOVA were used for categorical and continuous variables respectively. Breslow day score and multinomial and multiple logistic regression models were used.
Results
A total of 53,333 patients were analyzed. Using White race/ethnicity and sling surgery as references, Hispanic patients underwent more laparoscopic surgeries (OR1.17 [CI 1.03, 1.33]) and anterior vesico-urethropexy/urethropexies (OR 1.97 [CI 1.66, 2.34]); Black patients underwent more anterior vesico-urethropexy/urethropexies (OR 1.49 [CI 1.07, 2.07]), abdomino-vaginal vesical neck suspensions (OR 2.19 [CI 1.05–4.55]), and inflatable urethral slings (OR 4.28 [CI 1.23–14.90]). White patients had lower rates of inpatient stay (
p
< 0.0001) and blood transfusion (
p
< 0.0001) compared with patients who were Black, indigenous, people of color (BIPOC). Over time, Hispanic and Black patients were more likely to undergo anterior vesico-urethropexy/urethropexies than White patients (RR 2.03:1 [CI 1.72–2.40]) and (RR 1.59 CI [1.15–2.20]) respectively. Adjusting for possible confounders, Hispanic and Black patients had a greater chance of having a nonsling surgery, 37% (
p
< 0.0001) and 44% (
p
= 0.0001) greater chances respectively.
Conclusion
We observed racial/ethnic differences in SUI surgeries. Although causality cannot be proven here, our results confirm previous findings suggesting inequities in care.</description><subject>Cultural differences</subject><subject>Ethnicity</subject><subject>Gynecology</subject><subject>Hispanic people</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Race</subject><subject>Retrospective Studies</subject><subject>Suburethral Slings</subject><subject>Surgery</subject><subject>Urinary Bladder</subject><subject>Urinary incontinence</subject><subject>Urinary Incontinence, Stress - surgery</subject><subject>Urologic Surgical Procedures - methods</subject><subject>Urology</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1OxCAUhYnROOPoC7gwJG7cVC9QaLs0xr9kEhOja0IpVSYztAJdzNtL7aiJCxeEBL5z4J6D0CmBSwJQXAUAUtEMKMuA85JlfA_NSc5YxtLZPppDxYqM5YLO0FEIKwDIgcMhmrGCVZRSPkfqWWmr1li5Bpv47qzGjQ298jZusXXYqWg7l4DeKx2tNrhXMRrvAm47j0P0JgQ8eOuUHwW6c9E64xIYBv9m_PYYHbRqHczJbl-g17vbl5uHbPl0_3hzvcw0oyJmXFACouSUUyFYqZuKNGnlBc-rWkGdt1UNjeEl19CQJBGKFI3RRuiC5CVnC3Qx-fa--xhMiHJjgzbrtXKmG4KkJaO8EECrhJ7_QVfd4NOUiapIyURekJGiE6V9F4I3rey93aQxJQE5FiCnAmQKW34VIMdfnO2sh3pjmh_Jd-IJYBMQ0pVLAf2-_Y_tJ2BTkII</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Margulies, Samantha L.</creator><creator>Sakai, Nozomi</creator><creator>Geller, Elizabeth J.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5731-3740</orcidid></search><sort><creationdate>2024</creationdate><title>Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery</title><author>Margulies, Samantha L. ; Sakai, Nozomi ; Geller, Elizabeth J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-562106852526638cd91dd9147549ba0b4f9b0de585c0d13266a17dece6c714853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cultural differences</topic><topic>Ethnicity</topic><topic>Gynecology</topic><topic>Hispanic people</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Race</topic><topic>Retrospective Studies</topic><topic>Suburethral Slings</topic><topic>Surgery</topic><topic>Urinary Bladder</topic><topic>Urinary incontinence</topic><topic>Urinary Incontinence, Stress - surgery</topic><topic>Urologic Surgical Procedures - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Margulies, Samantha L.</creatorcontrib><creatorcontrib>Sakai, Nozomi</creatorcontrib><creatorcontrib>Geller, Elizabeth J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Margulies, Samantha L.</au><au>Sakai, Nozomi</au><au>Geller, Elizabeth J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2024</date><risdate>2024</risdate><volume>35</volume><issue>1</issue><spage>35</spage><epage>42</epage><pages>35-42</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of patients undergoing SUI surgery from 2010 to 2019. Chi-squared or Fisher’s exact test and ANOVA were used for categorical and continuous variables respectively. Breslow day score and multinomial and multiple logistic regression models were used.
Results
A total of 53,333 patients were analyzed. Using White race/ethnicity and sling surgery as references, Hispanic patients underwent more laparoscopic surgeries (OR1.17 [CI 1.03, 1.33]) and anterior vesico-urethropexy/urethropexies (OR 1.97 [CI 1.66, 2.34]); Black patients underwent more anterior vesico-urethropexy/urethropexies (OR 1.49 [CI 1.07, 2.07]), abdomino-vaginal vesical neck suspensions (OR 2.19 [CI 1.05–4.55]), and inflatable urethral slings (OR 4.28 [CI 1.23–14.90]). White patients had lower rates of inpatient stay (
p
< 0.0001) and blood transfusion (
p
< 0.0001) compared with patients who were Black, indigenous, people of color (BIPOC). Over time, Hispanic and Black patients were more likely to undergo anterior vesico-urethropexy/urethropexies than White patients (RR 2.03:1 [CI 1.72–2.40]) and (RR 1.59 CI [1.15–2.20]) respectively. Adjusting for possible confounders, Hispanic and Black patients had a greater chance of having a nonsling surgery, 37% (
p
< 0.0001) and 44% (
p
= 0.0001) greater chances respectively.
Conclusion
We observed racial/ethnic differences in SUI surgeries. Although causality cannot be proven here, our results confirm previous findings suggesting inequities in care.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37392225</pmid><doi>10.1007/s00192-023-05583-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5731-3740</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0937-3462 |
| ispartof | International Urogynecology Journal, 2024, Vol.35 (1), p.35-42 |
| issn | 0937-3462 1433-3023 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2832576029 |
| source | Springer Link |
| subjects | Cultural differences Ethnicity Gynecology Hispanic people Humans Medicine Medicine & Public Health Original Article Race Retrospective Studies Suburethral Slings Surgery Urinary Bladder Urinary incontinence Urinary Incontinence, Stress - surgery Urologic Surgical Procedures - methods Urology |
| title | Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T03%3A39%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Racial%20and%20ethnic%20disparity%20in%20national%20practice%20patterns%20for%20stress%20urinary%20incontinence%20surgery&rft.jtitle=International%20Urogynecology%20Journal&rft.au=Margulies,%20Samantha%20L.&rft.date=2024&rft.volume=35&rft.issue=1&rft.spage=35&rft.epage=42&rft.pages=35-42&rft.issn=0937-3462&rft.eissn=1433-3023&rft_id=info:doi/10.1007/s00192-023-05583-5&rft_dat=%3Cproquest_cross%3E2918364719%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c326t-562106852526638cd91dd9147549ba0b4f9b0de585c0d13266a17dece6c714853%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2918364719&rft_id=info:pmid/37392225&rfr_iscdi=true |