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  • Author
    Sarah Andebrhan
  • Co-author

    Alexandra Dubi‚Äčnskaya MD, Kai Dallas MD, A. Lenore Ackerman MD PhD

  • Title

    Racial Disparities in Outcomes in a Population-Based Cohort Undergoing Myomectomy for Fibroid Disease

  • Abstract

    Racial/ethnic disparities impact the care delivered as well as outcomes in numerous medical fields, including obstetrics and gynecology. Though most commonly discussed in the context of postpartum complications, the impact of race and ethnicity is seen in gynecologic outcomes, as well. The potential for disparity in the commonly performed myomectomy procedure has not been rigorously studied to date. A retrospective cohort study of all women who underwent non-hysteroscopic myomectomy was done using complete statewide data from January 1, 2005, through December 31, 2012, from the California Office of Statewide Health Planning and Development (OSHPD).The primary outcomes were choice of surgical approach, conversion to hysterectomy, and total and serious complications occurring within 30 days of the incident procedure. The cohort was racially and ethnically diverse (White-38.8%, Black-19.9%, Hispanic-20.3% and Asian-15.3%), and of the 35,151 women, 33,906 underwent open abdominal while 1,245 had minimally invasive myomectomies. Analysis showed that Black patients were more likely than White patients to undergo open procedures (4.8% vs. 1.3%, p<0.001), which were associated with higher complication rates (7.6% vs. 4.7%, p<0.001). Overall, 2,622 (7.5%) women suffered at least one complication. Black (9.0%), Hispanic (7.9%) and Asian (7.5%) patients were more likely to suffer complications as compared to White patients (6.7%, p<0.001). To ensure more equitable care, further research is warranted to identify the underlying reasons for these differences.

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