RESUMO
BACKGROUND: Our aim was to examine differences in clinical outcomes between Hispanic subgroups who underwent emergency general surgery (EGS). METHODS: Retrospective cohort study of the HCUP State Inpatient Database from New Jersey (2009-2014), including Hispanic and non-Hispanic White (NHW) adult patients who underwent EGS. Multivariable analyses were performed on outcomes including 7-day readmission and length of stay (LOS). RESULTS: 125,874 patients underwent EGS operations. 22,971 were Hispanic (15,488 with subgroup defined: 7,331 - Central/South American; 4,254 - Puerto Rican; 3,170 - Mexican; 733 - Cuban). On multivariable analysis, patients in the Central/South American subgroup were more likely to be readmitted compared to the Mexican subgroup (OR 2.02; p < 0.001, respectively). Puerto Rican and Central/South American subgroups had significantly shorter LOS than Mexican patients (Puerto Rico -0.58 days; p < 0.001; Central/South American -0.30 days; p = 0.016). CONCLUSIONS: There are significant differences in EGS outcomes between Hispanic subgroups. These differences could be missed when data are aggregated at Hispanic ethnicity.
Assuntos
Tratamento de Emergência/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Adulto , Idoso , América Central/etnologia , Cuba/etnologia , Bases de Dados Factuais , Tratamento de Emergência/mortalidade , Feminino , Cirurgia Geral/estatística & dados numéricos , Hispânico ou Latino/classificação , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , México/etnologia , Pessoa de Meia-Idade , Análise Multivariada , New Jersey , Readmissão do Paciente/estatística & dados numéricos , Porto Rico/etnologia , Estudos Retrospectivos , América do Sul/etnologia , Procedimentos Cirúrgicos Operatórios/mortalidadeRESUMO
BACKGROUND: The intrauterine device (IUD) is a long-acting reversible contraceptive method that is safe for a wide range of women, including adolescents and nulliparous women. Globally, it is often underutilised due to misperceptions among patients. Examination of characteristics associated with IUD discontinuation including adverse effects and IUD expulsion can inform provider practices to improve contraception success and patient satisfaction with this method. We studied IUD performance at a public family planning clinic in Buenos Aires, Argentina, serving a predominantly immigrant, low-income population. METHODS: We conducted a retrospective evaluation of 1047 IUD insertions between 2002 and 2007 with 5â years of follow-up data. We performed bivariate and survival analysis to examine characteristics associated with IUD discontinuation: adverse outcomes including pain, bleeding, and IUD expulsion, and time to removal. FINDINGS: Of 1047 patients, only 188 (18%) had their IUD removed within 5â years. The main causes of IUD discontinuation were involuntary (38%) reasons such as an IUD expulsion and personal choice (34%) such as desiring pregnancy. CONCLUSIONS: Findings suggest overall good long-term performance with IUD insertion, with minimal complaints or adverse outcomes. These findings may help to support providers serving similar populations in promoting this method.