D. Porras Fimbres1, D. P. Nussbaum2, P. Mosca3 1Duke University School of Medicine, Duke University Health System, Durham, NC, USA 2Duke University School of Medicine, Duke University Health System, Department Of Surgery, Durham, NC, USA 3Duke University Health System, Duke Network Services, Durham, NC, USA
Introduction: Early laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) may be associated with improved outcomes and shorter length of stay (LOS). The objective of this study was to compare time to surgery (TTS) between non-Hispanic Black (NHB) and non-Hispanic White (NHW) patients with AC undergoing LC.
Methods: Patients who underwent LC for AC from 2010-2020 were identified using the American College of Surgeons NSQIP database. Patients were categorized into NHW and NHB. Time to surgery, preoperative characteristics, and operative variables were analyzed on univariate and multivariable analysis.
Results: A total of 121,466 patients with LC for AC were included in this study (NHW=104,729, NHB=16,737). On univariate analysis, NHB patients were significantly more likely to experience TTS >1 day (19.4% vs 13.4%, p<0.0001). After adjusting for potential confounders, NHB patients had significantly greater odds (OR) for having TTS >1 day (OR 1.23, 95% CI 1.17-1.30, p<0.0001) (Table 1). Non-Hispanic Black patients had greater median operative times (69 versus 60 minutes, p<0.0001) and mean LOS (2.3 versus 1.7 days, p<0.0001). There were no significant differences in mortality (p=0.5155), major morbidity (p=0.4521), or overall morbidity (p=0.0826).
Conclusion: Non-Hispanic Black patients undergoing LC for AC experienced higher rates and had greater odds of surgical wait times greater than one day. Further research is needed to identify the causative factors of racial differences in surgical wait times. Surgeons should be aware that biases may adversely impact surgical management and should strive to identify and eliminate them to promote health equity in surgery.
