| Description |
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Background:
Robeson County is a rural community in North Carolina with the lowest life expectancy in North Carolina. While many risk factors contribute to these poor health outcomes, there is limited data on the comorbidities and outcomes related to surgical care for Robeson County.
Methods:
Surgical procedures performed at Duke Medical Center for patients from Robeson County were retrospectively reviewed. Patient demographics, comorbidities, disposition, surgical diagnosis, and surgical outcome were extracted from the medical record. Data was analyzed for all non-traumatic adult patients. Chi-square tests were used to compare categorical patient characteristics (age, sex, ASA physical status ≥ 3, and Elixhauser comorbidities). The ten most frequent surgical procedures were identified.
Results:
623 patients from Robeson County presented to Duke Health for surgical treatment in 2019-2021. Approximately half of the patients were from racial or ethnic minority groups (25% Black, 20% Native American, 2% Hispanic). Native American patients presented with the highest average BMI (31, P=.1) and highest percentage of patient deaths before discharge (n=8, 6.5%, P=.21) compared to all other racial and ethnic groups. Hispanic patients presented with the lowest average age at surgical presentation (53.7, P=.54). The most common co-morbidities were hypertension (n=230, 38.9%), arrhythmia (n=165, 27.9%), and congestive heart failure (n=166, 28%). The most common procedures were: Coronary Artery Bypass Graft (n=61, 10%), mastectomy (n=45, 7.9%), and transcatheter aortic valve replacement (n=30, 4.9%).
Conclusion:
Black, Native American, and Hispanic surgical patients from Robeson County presented to Duke Medical Center with the highest percentage of preoperative risk factors in at least one category compared to other racial and ethnic groups. The most common surgical interventions reflect the top two causes of death in Robeson County: cardiovascular disease and cancer. These findings represent a need for complex surgical oncology and cardiothoracic surgical care within the county.
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| Project Role |
- For this project, I cleaned and formatted that surgical case data that was extracted prior to the start of my research year. I conducted background research to identify what types of surgical risk factor and comorbidity categories the project would focus on with the guidance of my mentor. I conducted the statistical testing via RStudio for each category described in the abstract and manuscript, with coding fixes being made by our my research mentor and research assistant. Once I conducted the statistics, I created figures for all of the results, wrote every part of the manuscript, and discussion. My research mentor, Dr. Fitzgerald, research assistant, Olivia Kapera PhD, and surgery residents, Shannon Barter & Anthony Eze provided feedback an commentary on various sections of my work product. I designed the poster, wrote the abstract, and manuscript for this product.
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