The following is a summary of “Examining disparities among older multimorbid emergency general surgery patients: An observational study of Medicare beneficiaries,” published in the JUNE 2023 issue of Surgery by Roberts, et al.

Qualifying comorbidity sets (QCS) are tools to identify patients with multiple medical conditions (multimorbidity) who may have increased surgical risks. However, it remains to be seen how the QCS framework for assessing multimorbidity affects surgical risk in different racial groups.

The retrospective cohort study focused on Medicare patients aged 65.5 years or older who underwent an emergency general surgery operation between 2015 and 2018. The study examined the interaction between race and multimorbidity as the main exposure. The primary outcome was 30-day mortality, and secondary outcomes included routine discharge, 30-day readmission, length of hospital stay, and postoperative complications.

The study included a total of 163,148 patients who underwent emergency surgery. Among them, 13,852 (8.5%, P < 0.001) were Black, and 149,296 (91.5%, P < 0.001) were White. After risk adjustment, Black patients with multimorbidity did not show significant differences in 30-day mortality, routine discharge, or 30-day readmission compared to White patients with multimorbidity. Interestingly, Black patients with multimorbidity had significantly lower odds of experiencing postoperative complications (OR 0.89, P = 0.014) than White patients with multimorbidity.

The study, which focused on patients with universal insurance coverage, highlights the importance of pre-operative health status and its association with surgical outcomes, regardless of race. The QCS framework for multimorbidity did not demonstrate significant disparities in surgical risk between Black and White patients in the cohort.

Source: americanjournalofsurgery.com/article/S0002-9610(22)00736-X/fulltext