title: Characterizing Short-Term Outcomes Following Surgery for Rectal Cancer: the Role of Race and Insurance Status.
abstract: There is a paucity of data demonstrating the effect race and insurance status have on postoperative outcomes for patients with rectal cancer. We evaluated factors impacting short-term outcomes following rectal cancer surgery.
  
  
  
  Patients who underwent surgery for rectal cancer using the University Health System Consortium database from 2011 to 2012 were studied. Univariate and multivariable analyses were used to identify patient related risk factors for 30-day outcomes after proctectomy: complication rate, 30-day readmission, ICU stay, and length of hospital stay (LOS).
  
  
  
  A total of 9272 proctectomies were identified in this cohort. After adjustment for potential confounders, black patients were more likely to have 30-day readmissions (OR 1.51, 95 % CI 1.26-1.81), ICU stays (OR 1.25, 95 % CI 1.03-1.51), and longer LOS (+1.67 days, 95 % CI 1.21-2.13) when compared to whites. Compared to those with private insurance, patients with public or military insurance or who were self-pay had a higher likelihood of having postoperative complications.
  
  
  
  In patients who undergo elective proctectomy for rectal cancer, non-white and non-privately insured status are associated with significantly worse short-term outcomes. Further studies are needed to determine the implications with respect to receipt of adjuvant therapy and survival.
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA. sookchan06@gmail.com.
authors: Sook Y
authors: SY
authors: Chan
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Michigan, 2124 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors: Pasithorn A
authors: PA
authors: Suwanabol
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: Rachelle N
authors: RN
authors: Damle
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: Jennifer S
authors: JS
authors: Davids
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: Paul R
authors: PR
authors: Sturrock
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: W Brian
authors: WB
authors: Sweeney
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: Justin A
authors: JA
authors: Maykel
authors: Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA, 01605, USA.
authors: Karim
authors: K
authors: Alavi
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000208:ethnology; D012004:Rectal Neoplasms / Q000191:economics / Q000208:ethnology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
keywords: Anal neoplasia; Colorectal