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Black Men Less Likely to Choose Elective Stomach Aorta Surgery

White men more likely to have operation before emergency procedure is needed

TUESDAY, May 20 (HealthDay News) -- Black men are less likely than white men to have elective surgery to repair abdominal aortic aneurysms, a new study shows.

Researchers analyzed Medicare data on men 65 and older who had elective or urgent repairs between 2001 and 2003 to come to this conclusion.

An abdominal aortic aneurysm occurs when there's a ballooning or swelling in a segment of the aorta, the large artery that supplies blood to the abdomen, pelvis and legs. Elective surgery can be done before symptoms appear, while urgent surgery is done when an aneurysm ruptures, leaks, expands rapidly, or symptoms such as pain develop.

This study found that black men had elective surgery less than one third as often as white men (42.4 vs. 147.8 per 100,000 men) and urgent surgery about half as often (26.1 vs. 50.5 per 100,000 men).

After the researchers adjusted for that fact that black men develop abdominal aortic aneurysms at less than half the rate of white men, the researchers concluded that black men were about 27 percent less likely than white men to have elective surgery, but about 30 percent more likely to have urgent surgery.

Socioeconomic status is one of the possible reasons for the disparity, the study authors said.

"Although all of the patients in this study are Medicare beneficiaries, there may be substantial racial differences in comprehensiveness of Medicare benefits, supplemental insurance status and the ability to pay for health-care expenses not covered by Medicare," wrote Dr. Chad T. Wilson and colleagues. Wilson was with the VA Medical Center in White River Junction, Vt., but is now with Massachusetts General Hospital in Boston.

They also said black patients may not be treated the same as white patients. Doctors may be less likely to screen black patients as often because they're less likely to develop aortic aneurysms, or black patients may not be offered surgery for aneurysms the same size and structure as those of white patients.

"What seems clear is that the racial disparity in abdominal aortic aneurysm repair rate is not simply because of differences in disease prevalence," the authors concluded. "The fact that black men seem to need more urgent abdominal aortic aneurysm repairs than white men given their disease prevalence suggests that the racial disparity in the use of elective repair merits further investigation."

The study was published in the May issue of the Archives of Surgery.

More information

The Society of Interventional Radiology has more about abdominal aortic aneurysm.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, May 19, 2008

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