{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:15:27Z","timestamp":1787008527545,"version":"build-2736575974"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["22\/45"],"award-info":[{"award-number":["22\/45"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Indigenous populations worldwide experience unjust inequities in surgical outcomes. In Aotearoa New Zealand, Indigenous M\u0101ori experience poorer health outcomes, including higher rates of postoperative mortality. The aim of this study was to quantify ethnic disparities in \u2018failure to rescue\u2019 (FTR), complications, and mortality following gastrointestinal cancer surgery and to analyse trends over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective national population-based cohort study of patients undergoing resection for gastrointestinal and hepatopancreatobiliary cancers from 2005 to 2020 was conducted. Self-reported ethnicity data were collected at the time of surgery. The primary outcome was FTR, defined as mortality following a complication within 90 days of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 31 185 patients were included; 2479 (7.9%) were M\u0101ori, 46.5% were female, and the median age was 71 (interquartile range 62\u201378) years. M\u0101ori patients were younger and had higher levels of socio-economic deprivation and co-morbidity. M\u0101ori had higher age-standardized rates of mortality (5.9% versus 3.2%), complications (52.9% versus 42.4%), and FTR (10.8% versus 7.2%), compared with European\/Other. Multivariable regression demonstrated higher odds of mortality (adjusted OR (aOR) 1.45 (95% c.i. 1.15\u20131.82)), complications (aOR 1.30 (95% c.i. 1.17\u20131.45)), and FTR (aOR 1.29 (95% c.i. 1.01\u20131.62)) for M\u0101ori. Analysis over time showed a significant improvement in risk-adjusted rates of mortality (6.2% in 2005\u20132008 versus 3.4% in 2017\u20132020) and FTR (7.3% in 2005\u20132008 versus 4.0% in 2017\u20132020) for European\/Other, but no change for M\u0101ori (rates of mortality were 6.6% in 2005\u20132008 versus 5.4% in 2017\u20132020 and rates of FTR were 7.8% in 2005\u20132008 versus 6.3% in 2017\u20132020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Widening inequities in FTR have worsened disparities in postoperative mortality for M\u0101ori patients. \u2018Complication rescue\u2019 is a target to reduce inequities and improve perioperative care for M\u0101ori patients.<\/jats:p>\n                  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