Racial disparities of adrenalectomy

Purpose: Racial disparities of surgical outcomes have been demonstrated for a variety of operations. We sought to determine whether minority status is associated with disparate care for adrenalectomy. Methods: This study is a retrospective database review of the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) from January 1, 2014 through April 30, 2018. Primary outcome was complication rate. Secondary outcomes were length of stay and surgeon experience. Minority status was defined as Black or Hispanic and outcomes were compared with White patients. Results: For the study period, 1141 patients who underwent adrenalectomies were included, of whom 69.9% were White and 22.6% minority. The minority patients were significantly younger with higher rates of diabetes mellitus. Minority patients had higher rates of complication and longer length of stay. Minority patients were more likely to have an adrenalectomy by a low-volume surgeon. In multivariate logistic regression, minority status remained associated with complication rate. Conclusions: Minority patients undergoing adrenalectomy have higher rates of complication and longer lengths of stay when controlling for common comorbidities. Minority patients have decreased access to high-volume surgeons.