Hispanic/Latino Ethnicity and Loss of Post-Surgery Independent Living: A Retrospective Cohort Study from a Bronx Hospital Network
Issued Date
2024-09-01
Resource Type
eISSN
15267598
Scopus ID
2-s2.0-85201724799
Pubmed ID
38441101
Journal Title
Anesthesia and analgesia
Volume
139
Issue
3
Start Page
629
End Page
638
Rights Holder(s)
SCOPUS
Bibliographic Citation
Anesthesia and analgesia Vol.139 No.3 (2024) , 629-638
Suggested Citation
Witt A.S., Rudolph M.I., Sterling F.D., Azimaraghi O., Wachtendorf L.J., Medrano E.M., Joseph V., Akeju O., Wongtangman K., Straker T., Karaye I.M., Houle T.T., Eikermann M., Aguirre-Alarcon A. Hispanic/Latino Ethnicity and Loss of Post-Surgery Independent Living: A Retrospective Cohort Study from a Bronx Hospital Network. Anesthesia and analgesia Vol.139 No.3 (2024) , 629-638. 638. doi:10.1213/ANE.0000000000006948 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/100637
Title
Hispanic/Latino Ethnicity and Loss of Post-Surgery Independent Living: A Retrospective Cohort Study from a Bronx Hospital Network
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: Black race is associated with postoperative adverse discharge to a nursing facility, but the effects of Hispanic/Latino ethnicity are unclear. We explored the Hispanic paradox , described as improved health outcomes among Hispanic/Latino patients on postoperative adverse discharge to nursing facility. METHODS: A total of 93,356 adults who underwent surgery and were admitted from home to Montefiore Medical Center in the Bronx, New York, between January 2016 and June 2021 were included. The association between self-identified Hispanic/Latino ethnicity and the primary outcome, postoperative adverse discharge to a nursing home or skilled nursing facility, was investigated. Interaction analysis was used to examine the impact of socioeconomic status, determined by estimated median household income and insurance status, on the primary association. Mixed-effects models were used to evaluate the proportion of variance attributed to the patient's residential area defined by zip code and self-identified ethnicity. RESULTS: Approximately 45.9% (42,832) of patients identified as Hispanic/Latino ethnicity and 9.7% (9074) patients experienced postoperative adverse discharge. Hispanic/Latino ethnicity was associated with lower risk of adverse discharge (relative risk [RR adj ] 0.88; 95% confidence interval [CI], 00.82-0.94; P < .001), indicating a Hispanic Paradox . This effect was modified by the patient's socioeconomic status ( P -for-interaction <.001). Among patients with a high socioeconomic status, the Hispanic paradox was abolished (RR adj 1.10; 95% CI, 11.00-1.20; P = .035). Furthermore, within patients of low socioeconomic status, Hispanic/Latino ethnicity was associated with a higher likelihood of postoperative discharge home with health services compared to non-Hispanic/Latino patients (RR adj 1.06; 95% CI, 11.01-1.12; P = .017). CONCLUSIONS: Hispanic/Latino ethnicity is a protective factor for postoperative adverse discharge, but this association is modified by socioeconomic status. Future studies should focus on postoperative discharge disposition and socioeconomic barriers in patients with Hispanic/Latino ethnicity.