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American Indians and Alaska Native veterans have higher mortality rate after surgery than Caucasians

HANOVER, NH/WHITE RIVER JUNCTION, VT Contributing to growing literature on marked racial and ethnic disparities in US healthcare, a study led by Dartmouth Medical School has concluded that American Indians and Alaska Natives have a greater chance of death within 30 days of surgery and suffer more from several preoperative risks compared to Caucasian patients.

Published in the June issue of the Journal of the American College of Surgeons (JACS), the Dartmouth Medical School-led study is the largest to explore surgical outcomes in the American Indian population. The study examined data on 4,419 male patients at Veterans Affairs (VA) hospitals across the country.

"As a nation, we want to deliver healthcare that is equal across all ethnic groups and races, but we're finding that some disparities exist," said lead author, Dr. Lori Arviso Alvord, assistant professor of surgery and of psychiatry at Dartmouth Medical School. "The results of this study add surgical outcomes to the list of health disparities experienced by Native Americans and offer further opportunities for investigation, intervention, and improvement in this understudied population."

Patients in the study were selected from the Veterans Affairs National Surgical Quality Improvement Program (NSQIP), an ongoing government-funded program that provides risk-adjusted surgical morbidity and mortality data to measure the quality of care at VA hospitals. A total of 2,155 American Indians and Alaska Natives in the NSQIP database who had surgery between 1991 and 2002 were matched by facility to an equal number of randomly selected Caucasian patients. Alvord and colleagues found a significant difference in mortality rates after surgery, with 3.1% of American Indians dying compared to 2.2% of Caucasian patients.

"We want to be sure that differences in the care American Indians receive is not the reason for this disparity," said Alvord, who has clinical appointments at Dartmouth-Hi
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Contact: Andy Nordhoff
W.Andrew.Nordhoff@Dartmouth.edu
603-650-1492
Dartmouth Medical School
1-Jun-2005


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