Race Does Not Affect Rates of Surgical Complications at Military Treatment Facility

Mil Med. 2024 Aug 30;189(9-10):e2140-e2145. doi: 10.1093/milmed/usad502.

Abstract

Introduction: Racial minorities have been found to have worse health care outcomes, including perioperative adverse events. We hypothesized that these racial disparities may be mitigated in a military treatment facility, where all patients have a military service connection and are universally insured.

Materials and methods: This is a single institution retrospective review of American College of Surgeons National Surgical Quality Improvement Program data for all procedures collected from 2017 to 2020. The primary outcome analyzed was risk-adjusted 30-day postoperative complications compared by race.

Results: There were 6,941 patients included. The overall surgical complication rate was 6.9%. The complication rate was 7.3% for White patients, 6.5% for Black patients, 12.6% for Asian patients, and 3.4% for other races. However, after performing patient and procedure level risk adjustment using multivariable logistic regression, race was not independently associated with surgical complications.

Conclusions: Risk-adjusted surgical complication rates do not vary by race at this military treatment facility. This suggests that postoperative racial disparities may be mitigated within a universal health care system.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Military Personnel / statistics & numerical data
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / ethnology
  • Postoperative Complications* / etiology
  • Retrospective Studies
  • United States / epidemiology