title: Racial disparity in in-hospital mortality after lobectomy for lung cancer.
abstract: BACKGROUND
  Using data from the Nationwide Inpatient Sample, we investigated the impact of surgical approach and race on in-hospital mortality after lobectomy for lung cancer.
  
  
  METHODS
  Logistic regression was used to model odds ratios for in-hospital mortality related to surgical technique (thoracotomy vs video assisted thoracoscopic surgery [VATS]) and race using discharge data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (2008 to 2011).
  
  
  RESULTS
  VATS lobectomies increased each year (25.9% to 39.2%, P = .001) in the 19,353 patients identified. A racial disparity was noted, with black patients being 66% more likely to die in the hospital (odds ratio 1.66, 95% confidence interval 1.17 to 2.37, P = .005). Excluding 2010 data suggests that there is evidence of benefit associated with VATS; however, no evidence of an association between race and in-hospital mortality exists.
  
  
  CONCLUSIONS
  This study elucidates race-related mortality in lobectomy patients. Although racial disparities are present throughout health care, this finding emphasizes one of the challenges in using large databases to assess such disparities.
authors: Division of General Surgery, Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA 19107, USA.
authors: Meredith A
authors: MA
authors: Harrison
authors: Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Philadelphia, PA, USA.
authors: Sarah E
authors: SE
authors: Hegarty
authors: Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Philadelphia, PA, USA.
authors: Scott W
authors: SW
authors: Keith
authors: Division of Cardiothoracic Surgery, Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA, USA.
authors: Scott W
authors: SW
authors: Cowan
authors: Division of Cardiothoracic Surgery, Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA, USA. Electronic address: nathaniel.evans@jefferson.edu.
authors: Nathaniel R
authors: NR
authors: Evans
mesh_terms: D001741:Black or African American; D000368:Aged; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality*; D020775:Thoracic Surgery, Video-Assisted; D044465:White People
keywords: Lobectomy; Lung cancer; Nationwide Inpatient Sample; Racial disparity; VATS