Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Nikita Kohli

Abstract

Racial and Sex Disparities in Adult Reconstructive Airway Surgery Outcomes: An ACS NSQIP Analysis Tagan Rohrbaugh and Nikita Kohli. Department of Otolaryngology, Yale University, School of Medicine, New Haven, CT.

Previous studies demonstrated postoperative adverse events associated with pediatric airway reconstruction surgery using the National Surgery Quality Improvement Program-Pediatric (NSQIP-P) database. However, postoperative adverse events using the NSQIP database has not yet been described in adults. This study uses the NSQIP database to examine postoperative complications of airway reconstruction surgery in the setting of racial and sex disparities. Current procedural terminology (CPT) codes were used to identify 260 patients 18 years or older who underwent airway reconstruction from the 2005 to 2020 NSQIP public use files (PUF). Targeted independent variables included sex and race, and dependent variables were 30-day postoperative complications. Event rates were compared within subgroups. Chi-square tests were used to determine differences in comorbidities between race groups. Fisher’s exact test was used to determine difference in comorbidities between sex groups and white and black/African American groups. Analysis of variance (ANOVA) was performed for age, BMI, probability of morbidity and probability of mortality to determine statistical significance between race groups and sex groups. Linear regression analysis was used to identify significant factors for adverse events within race groups and within sex groups, controlling for age and BMI. Patients who identified as black/African American were significantly more likely to have several comorbidities when compared to white patients. Black/African American race was related to increased morbidity probability (P = 0.02), diabetes (P = 0.043), smoking status within 1 year (P = 0.008), and hypertension (P = 0.01). However, black/African American race was not associated with any surgical complications following airway reconstruction surgery. Sex for patients in this dataset was classified as either male or female. Comparison of sex revealed no significant difference in post-operative complications following airway reconstruction surgery. While African American race is an identifiable risk factor in several comorbidities, race is not significant when comparing post-operative complications. Additionally, sex does not contribute significantly to post-operative complications. Findings imply that while racial disparities are present in other surgical outcomes, they are absent in adult airway reconstruction surgery. Likewise, sex disparities are not present in airway reconstruction surgery outcomes.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS