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Session: ePoster: IBD 5 (Mon115)

EP789 - Disparities in Inflammatory Bowel Disease Surgical Outcomes: A NSQIP-IBD Analysis

Monday, May 12, 2025
1:20 PM – 1:25 PM PT

    ePoster Presenter(s)

  • VH

    Van Hoang, MD

    Resident
    The University of North Carolina at Chapel Hill
    Durham, North Carolina, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • WL

    William Y. Luo, MD, MAS

    Resident
    The University of North Carolina at Chapel Hill
    Durham, California, United States

    Disclosure information not submitted.

  • Kevin A. Chen, MD

    Resident
    The University of North Carolina at Chapel Hill
    University of North Carolina
    Durham, North Carolina, United States

    Disclosure information not submitted.

  • RL

    Ryan Lupo, MD

    Resident
    The University of North Carolina at Chapel Hill
    Durham, North Carolina, United States

    Disclosure information not submitted.

  • JS

    Jonathan Stem, MD

    Assistant Professor of Surgery, Associate Program Director General Surgery Residency
    The University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

    Disclosure information not submitted.

  • TW

    Trevor Wood, MD

    Assistant Professor
    The University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • MK

    Muneera Rehana Kapadia, MD

    Professor
    University of North Carolina at Chapel Hill
    Chapel Hill, NC, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Van Hoang, MD: This individual has no financial relationships with ineligible companies.
Muneera Rehana Kapadia, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Racial disparities in colorectal surgery have been well documented, with many studies identifying differences in outcomes between non-White and White patients. These studies mainly focused on patients in the elective setting undergoing all types of colorectal surgery. There are limited studies utilizing a database specific to Inflammatory Bowel Disease (IBD) that compares surgical outcomes among patients who undergo both elective and emergent surgery.

Methods/Interventions: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) IBD collaborative database from 2017 to 2023 was queried for all subjects with ICD-10 codes suggesting a diagnosis of IBD (K50.XX and K51.XX). Exclusion criteria included missing data for the following variables: race, ethnicity, placement of ileostomy, and designation of emergent or elective surgery. Primary outcomes were any post-operative complications and ileostomy formation. Secondary outcomes were length of stay (LOS), 30-day readmission rate and unplanned return to the operating room. For each outcome, we performed multivariable logistic regression with stepwise covariate selection by Akaike Information Criterion (AIC).

Results/Outcomes: Our cohort included 2613 patients, with a median age of 40 years. Most of our patients were Non-Hispanic White (91%), followed by Non-Hispanic Black (5%), and Hispanic (2%). There were 93 (3.6%) emergent cases. On univariate analysis, non-White patients had a significantly higher BMI (p < 0.0001), with Hispanic patients having the highest median BMI of 26 (IQR 6.8), followed by Non-Hispanic Black with 25 (IQR 8.8), and then Non-Hispanic White with 24 (IQR 7.4). Post-operative complications were grouped according to Clavien-Dindo Classification, and there were no significant differences between groups. There was also no association between race/ethnicity and readmission rates and returns to the operating room. On multivariate analysis, there were no differences between racial groups with regards to frequency of emergent versus elective surgeries. Among all IBD patients, Hispanic patients had a longer LOS (+3.7 days, 95% CI 1.5-5.8 days, p=0.0008) compared to non-Hispanic White patients. In a sub-analysis for Crohn’s Disease, Hispanic patients had a significantly higher likelihood of receiving a new ileostomy (OR 2.87, 95% CI 1.14-7.10, p=0.02), compared to non-Hispanic White patients.

Conclusion/Discussion: In this IBD-specific analysis, we found no significant association between race/ethnicity and emergent surgery or overall post-operative complications. However, Hispanic patients had longer hospitalizations, and specifically in Crohn’s disease, also had a higher likelihood of receiving an ileostomy. These findings suggest the presence of racial disparities and other patient specific barriers in the surgical care of Hispanic patients with IBD, highlighting a need for further research to improve care for these patients.