Open Access Research Article

Patients with Low Socioeconomic Status are More Likely to Present for Non-Elective Ovarian Cancer Surgery

Rachel L Budker1, Alexandra L Mardock2, Sarah E Rudasill2, Natsai C Nyakudarika, MD3, Peyman Benharash, MD3 and Joshua G Cohen, MD3*

1David Geffen School of Medicine, University of California, USA

2Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine at University of California, USA

3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, USA

Corresponding Author

Received Date:September 03, 2021;  Published Date: September 16, 2021


Objective: Our objective was to characterize the association between demographic features and perioperative outcomes in patients undergoing non-elective ovarian cancer surgery.

Methods: Women undergoing ovarian cancer surgery between 2010 and 2015 were identified in the Nationwide Readmissions Database. Patients were divided by whether they had elective or non-elective surgery. Demographic and clinical characteristics, post-operative outcomes including length of stay, adjusted costs at index hospitalization, readmission rates, and mortality were compared between groups. Multivariable analyses were employed to assess the association between baseline characteristics and non-elective surgery, and relevant clinical outcomes.

Results: Of 101,993 patients undergoing ovarian cancer surgery, 19,349 (19.0%) were classified as non-elective. Non-elective patients were more likely to have Medicaid coverage (13.3 vs. 6.4%, p<0.001) and had a higher average Elixhauser Comorbidity Index (3.7 vs. 3.2, p<0.001). Significant predictors of non-elective admission included lowest income quartile relative to highest (odds ratio (OR)=1.27 [1.12-1.43]) and age <50 relative to age > 70 (OR=1.62 [1.45-1.82]). Multivariable analysis revealed that patients presenting for non-elective surgery had significantly higher in-hospital mortality (OR=2.82 [95% Confidence Interval (CI)=2.22-3.58]) and 30-day readmission rates (OR=1.25 [1.15-1.36]). Patients presenting non-electively spent 3.3 more days in the hospital [95%CI: 3.0-3.5]) with $6,188 more in adjusted costs [95%CI: $5,497-6,879].

Discussion: The rate of non-elective ovarian cancer surgery remains high, with increased patient mortality and resource utilization. An independent association between lower income, public insurance, and increased rate of non-elective surgery was observed, highlighting the need to address low socioeconomic populations at risk for ovarian cancer to prevent emergent hospitalization.

Keywords: Ovarian cancer; Non-elective admission; Socioeconomic status

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