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Lower screening rates and poorer outcomes for colorectal cancer have been associated with Hispanic ethnicity and Spanish-speaking status, respectively.We reviewed sequential colorectal cancer patients evaluated by the surgical service at a safety-net hospital (SNH) (2016-2019). Insurance type, stage, cancer type, surgery class (elective/urgent), initial surgeon contact setting (outpatient clinic/inpatient consult), operation (resection/diversion), and follow-up were compared by patient-reported primary spoken language.Of 157 patients, 85 (54.1%) were men, 91 (58.0%) had colon cancer, 67 (42.7%) primarily spoke Spanish, and late stage (III or IV) presentations occurred in 83 (52.9%) patients. The median age was 58 y, cancer resection was completed in 48 (30.6%) patients, and 51 (32.5%) patients were initially seen as inpatient consults. On univariate analysis, Spanish-speaking status was significantly associated with female sex, Medicaid insurance, being seen as an outpatient consult, and undergoing elective and resection surgery. On multivariable logistic regression, Spanish-speaking patients had higher odds of having Medicaid insurance (AOR 2.28, P = 0.019), receiving a resection (AOR 3.96, P = 0.006), and undergoing an elective surgery (AOR 3.24, P = 0.025). Spanish-speaking patients also had lower odds of undergoing an initial inpatient consult (AOR 0.34, P = 0.046).Spanish-speaking status was associated with a lower likelihood of emergent presentation and need for palliative surgery among SNH colorectal cancer patients. Further research is needed to determine if culturally competent infrastructure in the SNH setting translates into Spanish-speaking status as a potentially protective factor.

Modifiable risk factors associated with procedure-related 30-day readmission after emergency general surgery (EGS) have not been comprehensively studied. We set out to determine risk factors associated with EGS procedure-related 30-d unplanned readmissions.A retrospective cohort study was conducted using the NSQIP database (2013-2019). It included 9 surgical procedures encompassing 80% of the burden of EGS diseases, performed on an urgent/emergent basis. The procedures were classified as low risk (open and laparoscopic appendectomy and laparoscopic cholecystectomy) and high risk (open cholecystectomy, laparoscopic and open colectomy, lysis of adhesions, perforated ulcer repair, small bowel resection, and exploratory laparotomy). Data on patient characteristics, admission status, procedure risk, hospital length of stay (HLOS), and discharge disposition were analyzed by multivariate logistic regression.A total of 312,862 patients were included [16,306 procedure-related 30-d readmissions (5.2%)]. 30-day readmission patients were older, had higher ASA scores, were more often underweighted or markedly obese, and more frequently presented with sepsis. Risk factors associated with EGS procedure-related 30-d unplanned readmissions included Age40 years (AOR = 1.15), ASA ≥ 3 (AOR = 1.41), sepsis present at the time of surgery (AOR = 1.84), BMI18 (AOR = 1.16), BMI ≥ 40 (AOR = 1.12), high-risk procedures (AOR = 1.51), LOS ≥ 4 d (AOR = 2.04), and discharge except to home (AOR = 1.33). 30-day readmissions following low-risk procedures occurred at a median of 5 days (IQR: 2-11), and 6 days (IQR:3-11) after high-risk procedures. Surgical site infections, postop sepsis, wound disruption, and thromboembolic events were more prevalent in the 30-d readmission group. Mortality rate was 4-fold higher in the 30-d readmission group (2.4% vs. 0.6%).We identified several unmodifiable patients and EGS disease-related factors associated with 30-day unplanned readmissions. Readmissions could be potentially reduced by the implementation of a post-discharge surveillance systems between hospitals and post-discharge destination facilities, leveraging telehealth and outpatient care.III, Prognostic and Epidemiological.