{"id":23699,"date":"2023-04-15T04:47:00","date_gmt":"2023-04-14T20:47:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23699"},"modified":"2023-04-15T05:49:35","modified_gmt":"2023-04-14T21:49:35","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd%e6%89%8b%e6%9c%af%e9%a2%84%e5%90%8e%e7%9a%84%e7%a7%8d%e6%97%8f%e4%b8%8e%e6%80%a7%e5%88%ab%e5%b7%ae%e5%bc%82","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23699","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd\u624b\u672f\u9884\u540e\u7684\u79cd\u65cf\u4e0e\u6027\u522b\u5dee\u5f02"},"content":{"rendered":"\n<p><strong>Research<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\" id=\"page-title\">Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Dan P Ly<a rel=\"noreferrer noopener\" href=\"https:\/\/orcid.org\/0000-0001-5760-0208\" target=\"_blank\"><\/a>, Mariah B Blegen, Melinda M Gibbons,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\"><em>BMJ<\/em>\u00a02023;\u00a0380\u00a0doi:\u00a0<a href=\"https:\/\/doi.org\/10.1136\/bmj-2022-073290\">https:\/\/doi.org\/10.1136\/bmj-2022-073290<\/a>\u00a0(Published 01 March 2023)Cite this as:\u00a0<em>BMJ<\/em>\u00a02023;380:e073290<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p id=\"p-2\"><strong>Objective<\/strong>&nbsp;To assess inequities in mortality by race and sex for eight common surgical procedures (elective and non-elective) across specialties in the United States.<\/p>\n\n\n\n<p id=\"p-3\"><strong>Design<\/strong>&nbsp;Retrospective cohort study.<\/p>\n\n\n\n<p id=\"p-4\"><strong>Setting<\/strong>&nbsp;US, 2016-18.<\/p>\n\n\n\n<p id=\"p-5\"><strong>Participants<\/strong>&nbsp;1\u2009868\u2009036 Black and White Medicare beneficiaries aged 65-99 years undergoing one of eight common surgeries: repair of abdominal aortic aneurysm, appendectomy, cholecystectomy, colectomy, coronary artery bypass surgery, hip replacement, knee replacement, and lung resection.<\/p>\n\n\n\n<p id=\"p-6\"><strong>Main outcome measure<\/strong>&nbsp;The main outcome measure was 30 day mortality, defined as death during hospital admission or within 30 days of the surgical procedure.<\/p>\n\n\n\n<p id=\"p-7\"><strong>Results<\/strong>&nbsp;Postoperative mortality overall was higher in Black men (1698 deaths, adjusted mortality rate 3.05%, 95% confidence interval 2.85% to 3.24%) compared with White men (21\u2009833 deaths, 2.69%, 2.65% to 2.73%), White women (21\u2009847 deaths, 2.38%, 2.35% to 2.41%), and Black women (1631 deaths, 2.18%, 2.04% to 2.31%), after adjusting for potential confounders. A similar pattern was found for elective surgeries, with Black men showing a higher adjusted mortality (393 deaths, 1.30%, 1.14% to 1.46%) compared with White men (5650 deaths, 0.85%, 0.83% to 0.88%), White women (4615 deaths, 0.82%, 0.80% to 0.84%), and Black women (359 deaths, 0.79%, 0.70% to 0.88%). This 0.45 percentage point difference implies that mortality after elective procedures was 50% higher in Black men compared with White men. For non-elective surgeries, however, mortality did not differ between Black men and White men (1305 deaths, 6.69%, 6.26% to 7.11%; and 16\u2009183 deaths, 7.03%, 6.92% to 7.14%, respectively), although mortality was lower for White women and Black women (17\u2009232 deaths, 6.12%, 6.02% to 6.21%; and 1272 deaths, 5.29%, 4.93% to 5.64%, respectively). These differences in mortality appeared within seven days after surgery and persisted for up to 60 days after surgery.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.bmj.com\/content\/bmj\/380\/bmj-2022-073290\/F1.large.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.bmj.com\/content\/bmj\/380\/bmj-2022-073290\/F2.large.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<p id=\"p-8\"><strong>Conclusions<\/strong>&nbsp;Postoperative mortality overall was higher among Black men compared with White men, White women, and Black women. These findings highlight the need to understand better the unique challenges Black men who require surgery face.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Research Inequities in surgical outcomes by race and se [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23699"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23699"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23699\/revisions"}],"predecessor-version":[{"id":23700,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23699\/revisions\/23700"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}