Racial Disparities in Outcomes After Major Head and Neck Surgery

OBJECTIVE: Understanding racial disparities in postoperative outcomes after major head and neck surgery is crucial in improving overall cancer survival. This study aims to investigate the association of race on surgical outcomes after major head and neck surgery. METHODS: The American College of Surgeon National Surgical Improvement Program is a nationally representative dataset with data collected via systematic sampling methods. Patients who underwent major head and neck cancer surgery were identified between 2014 and 2021 and grouped based on self-reported race/ethnicity. Continuous variables were compared using one-way ANOVA, while categorical variables were analysed using Pearson's chi-square test. Multivariate logistic regression controlled for preoperative factors was performed to identify independent predictors of postoperative outcomes and generate odds ratios. RESULTS: 68.2% of the cohort were White, with Black, Hispanic, Asian and unknown/not reported comprising 6.0%, 4.9%, 4.0% and 16.9%, respectively. In multivariate analysis, Black patients compared to White patients had significantly greater odds of experiencing overall complications (OR = 1.73; 95% CI 1.38-2.19), and severe complications (OR = 2.09; 95% CI 1.71-2.56) (definitions provided in Methods section). CONCLUSION: Significant racial disparities exist in complications following major head and neck cancer surgery, with a higher rate of complications in Black patients. Further research is required to identify those factors responsible for the disparity.