Ogunsina Kemi, Naik Gurudatta, Vin-Raviv Neomi, Akinyemiju Tomi F
Department of Epidemiology, University of Alabama at Birmingham, Birmingham AL, United States.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham AL, United States; Comprehensive Cancer Center. University of Alabama at Birmingham, Birmingham AL, United States.
Cancer Epidemiol. 2017 Aug;49:138-143. doi: 10.1016/j.canep.2017.06.002. Epub 2017 Jun 15.
The purpose of this study is to determine if racial disparities in inpatient outcomes persist among hospitalized patients comparing African American and White breast cancer patients matched on demographics, presentation and treatment.
A total of 136,211 African American and White breast cancer patients from the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS) database, matched on demographics alone, demographics and presentation or demographics, presentation and treatment were studied. Conditional logistic regression was conducted to evaluate post-surgical complications, length of stay and in-hospital mortality outcomes. Analysis was further stratified by age (≤65 years and >65years) to evaluate whether disparities were larger in younger or older patients. All analysis was conducted using SAS 9.3.
White women had significantly shorter hospital length of stay when matched on demographics (β=-0.87, p-value=<0.0001), demographics and presentation (β=-0.63, p-value=<0.0001), and demographics, presentation and treatment (β=-0.51, p-value=<0.0001) compared with African Americans. White women also had lower odds of mortality compared with African American women when matched on demographics (OR: 0.72, 95% CI: 0.65-0.79), demographics and presentation (OR: 0.77, 95% CI: 0.71-0.85), or matched on demographics, presentation and treatment (OR: 0.80, 95% CI: 0.73-0.88). The racial difference observed in length of stay and mortality was larger in the age group ≤65 years compared with >65years CONCLUSION: African American women experienced higher odds of inpatient mortality and longer length of stay compared with White women even after accounting for differences in demographics, presentation and treatment characteristics.
本研究的目的是确定在人口统计学、临床表现和治疗方面相匹配的住院患者中，非裔美国人和白人乳腺癌患者在住院结局方面的种族差异是否仍然存在。
对来自医疗成本和利用项目-全国住院患者样本（HCUP-NIS）数据库的136,211名非裔美国人和白人乳腺癌患者进行了研究，这些患者仅在人口统计学、人口统计学和临床表现或人口统计学、临床表现和治疗方面进行了匹配。进行条件逻辑回归以评估术后并发症、住院时间和院内死亡率结局。分析进一步按年龄（≤65岁和>65岁）分层，以评估年轻或老年患者的差异是否更大。所有分析均使用SAS 9.3进行。
与非裔美国人相比，白人女性在人口统计学匹配（β=-0.87，p值<0.0001）、人口统计学和临床表现匹配（β=-0.63，p值<0.0001）以及人口统计学、临床表现和治疗匹配（β=-0.51，p值<0.0001）时，住院时间明显更短。与非裔美国女性相比，白人女性在人口统计学匹配（OR：0.72，95%CI：0.65-0.79）、人口统计学和临床表现匹配（OR：0.77，95%CI：0.71-0.85）或人口统计学、临床表现和治疗匹配（OR：0.80，95%CI：0.73-0.88）时，死亡几率也更低。与>65岁的年龄组相比，≤65岁年龄组在住院时间和死亡率方面观察到的种族差异更大。
即使在考虑了人口统计学、临床表现和治疗特征的差异之后，与白人女性相比，非裔美国女性的住院死亡率几率更高，住院时间更长。
