术后恶心和呕吐护理的种族和民族差异。
Racial and Ethnic Differences in Postoperative Nausea and Vomiting Care.
发表日期:2024 Aug 23
作者:
Pascal Owusu-Agyemang, Olakunle Idowu, Arun Muthukumar, Juan Jose Guerra-Londono, Techecia Idowu, Nancy N Diaz, Lei Feng, Malachi Miller, Satvik Gundre, Crystal Wright, Juan P Cata
来源:
ANESTHESIA AND ANALGESIA
摘要:
医疗保健方面的种族和民族差异可能会导致显着的发病率。本研究的目的是确定患者的种族或民族与术前、手术期间和恢复室接受止吐剂之间是否存在关联。一项针对成年患者(> 18 岁)的单机构回顾性研究)于 2016 年 3 月至 2021 年 8 月期间在麻醉下接受了与癌症相关的手术室手术。拟合多变量逻辑回归模型来估计协变量对止吐给药的影响。在研究中纳入的 60,595 名患者中,3053 名 (5.0%) 自认为是亚洲人,5376 名 (8.9%) 为黑人,8431 名 (13.9%)西班牙裔或拉丁裔,42,533 名 (70.2%) 为白人,1202 名 (2.0%) 属于其他种族或族裔群体。多变量分析显示,患者的种族或民族与术前等候区、手术室和恢复室接受止吐药之间存在显着相关性(所有 P < .001)。在术前保留区,白人患者(42,533 例中的 8962 例 [21.1%];比值比 [OR],1.188;95% 置信区间 [CI],1.100-1.283;P < .001)接受止吐药的几率高于黑人患者(5376 名患者中的 1006 名 [18.7%])。术中,西班牙裔或拉丁裔患者(8431 例中的 7323 例 [86.9%];OR,1.175;95% CI,1.065-1.297;P = 0.001)以及被确定属于其他种族的患者(1202 例中的 1078 例)的几率明显更高[89.7%];OR,1.582;95% CI,1.290-1.941;P < .001)高于黑人患者(5376 名患者中的 4468 名[83.1%])。在康复室中,亚洲人(3053 人中的 499 人 [16.3%];OR,1.328;95% CI:1.127-1.561;P < .001)、西班牙裔或拉丁裔人(8431 人中的 1335 人[15.8%];OR,1.208;95 % CI,1.060-1.377;P < .005)和白人患者(42,533 例中的 6533 例 [15.4%];OR,1.276;95% CI,1.140-1.427;P < .001)接受止吐药的几率显着高于黑人患者(5376 名患者中的 646 名 [12%])。这项回顾性研究表明,不同种族或民族的患者服用止吐药之间存在显着差异,黑人患者接受止吐药的可能性往往低于所有其他种族或种族的患者。种族。版权所有 © 2024 国际麻醉研究协会。
Racial and ethnic differences in health care may result in significant morbidity. The objective of this study was to determine whether there was an association between a patient's race or ethnicity and the receipt of an antiemetic agent preoperatively, during surgery, and in the recovery room.A single-institution retrospective study of adult patients (>18 years) who had undergone cancer-related operating room procedures under anesthesia between March 2016 and August 2021 was conducted. A multivariable logistic regression model was fitted to estimate the effects of covariates on antiemetic administration.Of the 60,595 patients included in the study, 3053 (5.0%) self-identified as Asian, 5376 (8.9%) as Black, 8431 (13.9%) as Hispanic or Latino, 42,533 (70.2%) as White, and 1202 (2.0%) as belonging to another racial or ethnic group. Multivariable analyses showed significant associations between a patient's race or ethnicity and the receipt of antiemetics in the preoperative holding area, operating room, and recovery room (all P < .001). In the preoperative holding area, White patients (8962 of 42,533 [21.1%]; odds ratio [OR], 1.188; 95% confidence interval [CI], 1.100-1.283; P < .001) had higher odds of receiving an antiemetic than Black patients (1006 of 5376 [18.7%]). Intraoperatively, the odds were significantly greater for Hispanic or Latino (7323 of 8431 [86.9%]; OR, 1.175; 95% CI, 1.065-1.297; P = .001) and patients who identified as belonging to another race (1078 of 1202 [89.7%]; OR, 1.582; 95% CI, 1.290-1.941; P < .001) than for Black patients (4468 of 5376 [83.1%]). In the recovery room, Asian (499 of 3053 [16.3%]; OR, 1.328; 95% CI: 1.127-1.561; P < .001), Hispanic or Latino (1335 of 8431 [15.8%]; OR, 1.208; 95% CI, 1.060-1.377; P < .005), and White patients (6533 of 42,533 [15.4%]; OR, 1.276; 95% CI, 1.140-1.427; P < .001) had significantly higher odds of receiving antiemetics than Black patients (646 of 5376 [12%]).This retrospective study suggests significant differences between the administrations of antiemetics to patients of different races or ethnicities, with Black patients often being less likely to receive an antiemetic than patients belonging to all other races or ethnicities.Copyright © 2024 International Anesthesia Research Society.