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Cited by 188Thyroid and Parathyroid SurgeryHealth disparities and outcomesThyroid Disorders and Treatments

Racial Disparities in Clinical and Economic Outcomes From Thyroidectomy

Sosa, Julie Ann, Mehta, Pritesh J., Wang, Tracy S., Yeo, Heather L., Roman, Sanziana A.·2007·Annals of Surgery
DOI 10.1097/sla.0b013e31812eecc4
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Abstract

CONTEXT: Thyroid disease is common, and thyroidectomy is a mainstay of treatment for many benign and malignant thyroid conditions. Overall, thyroidectomy is associated with favorable outcomes, particularly if experienced surgeons perform it. OBJECTIVE: To examine racial differences in clinical and economic outcomes of patients undergoing thyroidectomy in the United States. DESIGN, SETTING, PATIENTS: The nationwide inpatient sample was used to identify thyroidectomy admissions from 1999 to 2004, using ICD-9 procedure codes. Race and other clinical and demographic characteristics of patients were collected along with surgeon volume and hospital characteristics to predict outcomes. MAIN OUTCOME MEASURES: Inpatient mortality, complication rates, length of stay (LOS), discharge status, and mean total costs by racial group. RESULTS: In 2003-2004, 16,878 patients underwent thyroid procedures; 71% were white, 14% black, 9% Hispanic, and 6% other. Mean LOS was longer for blacks (2.5 days) than for whites (1.8 days, P < 0.001); Hispanics had an intermediate LOS (2.2 days). Although rare, in-hospital mortality was higher for blacks (0.4%) compared with that for other races (0.1%, P < 0.001). Blacks trended toward higher overall complication rates (4.9%) compared with whites (3.8%) and Hispanics (3.6%, P = 0.056). Mean total costs were significantly lower for whites ($5447/patient) compared with those for blacks ($6587) and Hispanics ($6294). The majority of Hispanics (55%) and blacks (52%) had surgery by the lowest-volume surgeons (1-9 cases per year), compared with only 44% of whites. Highest-volume surgeons (>100 cases per year) performed 5% of thyroidectomies, but 90% of their patients were white (P < 0.001). Racial disparities in outcomes persist after adjustment for surgeon volume group. CONCLUSIONS: These findings suggest that, although thyroidectomy is considered safe, significant racial disparities exist in clinical and economic outcomes. In part, inequalities result from racial differences in access to experienced surgeons; more data are needed with regard to racial differences in thyroid biology and surveillance to explain the balance of observed disparities.

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Authors
Sosa, J. A., Mehta, P. J., Wang, T. S., Yeo, H. L., & Roman, S. A.
Affiliations
Yale University (US)
ORCID
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2007-12
Volume
246
Issue
6
Pages
1083-1091
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/sla.0b013e31812eecc4
OpenAlex
W2040133484
Cited by
188
References
29
Citations by year
2026: 4 · 2025: 6 · 2024: 13 · 2023: 19 · 2022: 21 · 2021: 31 · 2020: 16 · 2019: 11 · 2018: 7 · 2017: 4 · 2016: 9 · 2015: 8 · 2014: 5 · 2013: 8 · 2012: 6
FWCI
4.65
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Keywords
thyroidectomy, racial disparities, health care disparities, in-hospital mortality, postoperative complications, length of hospital stay, hospital costs, surgeon volume, Black patients, Hispanic patients, Caucasian patients
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Ethnicity, Female, Humans, Inpatients, Length of Stay, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Thyroid Diseases, Thyroidectomy, United States, Hospital Mortality, Hospital Costs

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