eP747 - The Impact of Limited English Proficiency on Perianal Fistula Treatment

ePoster Presenter(s)

• 

  Marhama Zafar, Bachelor of Medicine, Bachelor of Surgery (she/her/hers)

  Research Fellow
  University of Illinois Chicago
  University of Illinois Chicago
  chicago, IL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• MZ

  Muhammad Huzaifa Zafar, MD

  General surgery resident
  University of Connecticut
  Hartford, Connecticut, United States

  Disclosure information not submitted.
• MR

  Maria A. Rojas, MD

  Colon and Rectal Surgeon
  Colon and Rectal Clinic of Ft. Lauderdale
  Pompano Beach, Florida, United States

  Disclosure information not submitted.
• 

  Anders Mellgren, MD, PhD

  Chief, Colon & Rectal Surgery
  University of Illinois
  Chicago, Illinois, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• MA

  Mohamad A. Abdulhai, MD

  Assistant Professor
  University of Illinois at Chicago
  Chicago, Illinois, United States

  Disclosure information not submitted.
• VC

  Vivek Chaudhry, MD FACS FASCRS

  Clin Assoc Prof
  UNIVERSITY OF ILLINOIS
  Chicago, Illinois, United States

  Disclosure information not submitted.
• EB

  Elisa Maria Bianchi, MD

  Colorectal Surgeon
  University of Illinois at Chicago
  Chicago, Illinois, United States

  Disclosure information not submitted.
• GG

  Gerald Gantt, MD

  Assistant Professor of Surgery
  University of Illinois Chicago
  Chicago, Illinois, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Senior Author(s)

• AP

  Alejandra M. Perez-Tamayo, MD

  Assistant Professor of Surgery, Colon and Rectal Surgery Division
  UI Health, University of Illinois
  Chicago, Illinois, United States

  Disclosure information not submitted.

Purpose/Background: Limited English Proficiency (LEP) can be a barrier between patients and their healthcare providers. Approximately, 8 percent (25.1 million people) in The United States, do not speak English as their primary language. In this study, we aimed to evaluate the impact of LEP in patients being treated for perianal fistula.Methods/Interventions: Retrospective review of patients undergoing surgical treatment for perianal fistula 2015-2020 at two large tertiary referral centers was performed. Patients who required an interpreter or preferred a language other than English were considered LEP. These patients were then matched with English proficient (EP) patients based on the complexity of the fistula and the surgical procedure used for definitive treatment. Variables evaluated included average length of post-operative follow up, time duration from seton placement till definitive repair, time duration from fistula diagnosis till definitive repair and the total number of surgical procedures performed. Patients who failed to complete their visits as recommended by their physician were considered lost to follow up.Results/Outcomes: A total of 77 LEP patients were treated for perianal fistula, 25 of whom had complex fistulas. These patients were matched with 77 EP patients and both groups had similar mean age and mean BMI. Both groups had 57 patients who received definitive surgical repair. The median length of postoperative follow up for LEP patients with simple fistula was significantly less than EP patients with simple fistula (60 days vs 127 days, p=0.001) which was a trend seen in complex fistula disease as well. There was no difference in lost to follow up of patients in either fistula groups (simple 42% vs 56%, p=0.65; complex 56% vs 64%, p=0.34). Time interval between fistula diagnosis and definitive repair as well as the duration between seton placement and definitive repair were not significantly different among the study populations. Similarly, neither group displayed any significant difference in the total number of surgical procedures performed for perianal fistula repair.Conclusion/

Discussion: Many studies have been conducted to demonstrate the effect of LEP in healthcare. Most of them have stressed upon the delays and quality of medical care received by LEP patients. However, our results demonstrated similar surgical outcomes in LEP patients when compared to EP patients. This may be a result of providing patient instructions in the appropriate language and enhanced use of professional interpreters when treating the LEP patient population. Language is an integral component of culture and allows healthcare professionals to establish mutual trust and respect with their patients. Providing culturally competent care can mitigate potential disparities in the management of anal fistula patients.The Impact of Limited English Proficiency on Perianal Fistula TreatmentLEP= Limited English Proficient, EP= English Proficient