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- W4306253639 abstract "INTRODUCTION: Emergency general surgery (EGS) includes operative and nonoperative management; however, it is unknown whether the decision to operate affects Black and White patients differently. We hypothesized that the difference in outcomes between operative and nonoperative management would be greater for Black patients. METHODS: We identified a nationwide cohort of Black and White Medicare beneficiaries, age >65.5 years, hospitalized for common EGS conditions (July 2015 to June 2018). Using near-far matching to adjust for measurable confounding and an instrumental variable analysis to control for selection bias associated with treatment assignment, we compare outcomes of operative and nonoperative management in a stratified population of Black and White patients. Outcomes included 30-day mortality and readmission. Adjusted risk differences between racial groups were compared using a test for interaction. RESULTS: A total of 42,207 Black and 397,070 White patients were included; 23.9% of Black and 30.8% of White patients underwent operative management. After matching operative and nonoperative patients, standardized differences between all measured covariates were <0.05 for both racial groups. See Figure 1 for risk differences between treatments, stratified by race. Significant outcome differences were seen between operative and nonoperative management for some conditions; however, no significant differences were seen for the conditional effect of race on outcomes.Figure 1CONCLUSION: Using an instrumental variable analysis to control for selection bias and matching to adjust for measurable confounders, operative management had varying effects on outcomes by condition regardless of race. Similar outcomes were observed between Black and White patients, suggesting equitable care in the national population of older adults hospitalized with common EGS conditions." @default.
- W4306253639 created "2022-10-15" @default.
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- W4306253639 date "2022-10-17" @default.
- W4306253639 modified "2023-09-27" @default.
- W4306253639 title "Conditional Effects of Race on Operative and Nonoperative Outcomes of Emergency General Surgery" @default.
- W4306253639 doi "https://doi.org/10.1097/01.xcs.0000893496.56449.3c" @default.
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