title: The impact of Hispanic ethnicity and race on post-surgical complications in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Surgery for inflammatory bowel disease (IBD) is common and represents a large portion of the cost of IBD treatment. There are multiple risk factors for post-operative complications after IBD surgery, but the role of ethnicity remains unclear. The aim of our study was to compare the rate of post-operative complications in Hispanic and non-Hispanic patients with equal access to health care.
  
  
  METHODS
  We designed a case-control study including patients enrolled in a health plan available to uninsured patients at Jackson Memorial Hospital (Miami, FL, USA) who had access to health care for at least 24 consecutive months prior to surgery. Sixty-seven Hispanic patients (cases) and 75 non-Hispanic patients (controls) met criteria and were compared with respect to demographics, type of surgery, disease phenotype, and laboratory markers. Primary outcome was the development of a medical or surgical complication.
  
  
  RESULTS
  A slight numerical increase in post-operative complications was seen in Hispanic patients; this did not reach statistical significance [1.06 (95 % CI 0.48-2.36; p = 0.88)]. Factors independently associated with post-operative complications included diagnosis of ulcerative colitis [OR 5.4 (95 % CI 1.67-20.58; p = 0.004)], pre-operative albumin levels <3 mg/dL [OR: 8.2 (95 % CI 2.3-35.5; p < 0.001)], smoking [OR 15.7 (95 % CI 4.2-72.35; p < 0.001)], and use of ≥20 mg of prednisone [OR 6.7 (95 % CI 2.15-24.62; p < 0.001)].
  
  
  CONCLUSIONS
  In a group of patients with equal access to medical care and follow-up, Hispanics and non-Hispanics with IBD that underwent surgery had no significant differences in types of IBD surgeries or post-surgical outcomes.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building 350 (D-49), Miami, FL, 33136, USA, ajyarur@gmail.com.
authors.forename: Andres J
authors.initials: AJ
authors.lastname: Yarur
authors.forename: Maria T
authors.initials: MT
authors.lastname: Abreu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Salem
authors.forename: Amar R
authors.initials: AR
authors.lastname: Deshpande
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Sussman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000601:surgery*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000208:ethnology*; D016896:Treatment Outcome; D055815:Young Adult