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炎症性肠病住院结局的种族差异:一项全国基于人群的研究。

Racial differences in the outcomes of IBD hospitalizations: a national population-based study.

机构信息

Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, 60612, USA.

Department of Internal Medicine, Coney Island Hospitals & Health Systems, Brooklyn, NY, 11235, USA.

出版信息

Int J Colorectal Dis. 2022 Jan;37(1):221-229. doi: 10.1007/s00384-021-04052-z. Epub 2021 Oct 25.

Abstract

PURPOSE

There are  scarce data describing the outcomes of hospitalized patients admitted with inflammatory bowel disease (IBD) stratified by race. In this retrospective cohort study, we evaluated the difference in outcomes between adult white and black patients hospitalized with a principal diagnosis of inflammatory bowel disease.

METHODS

Data were obtained from the 2016 and 2017 National Inpatient Sample (NIS) database. Our primary outcome was inpatient mortality while the secondary outcomes were hospital length of stay (LOS), total hospital charges (THC), red blood cell (RBC) transfusion, diagnosis of bowel perforation, and severe sepsis with septic shock. We conducted the analysis using STATA software. We used propensity-matched multivariate regression analysis to adjust for potential confounders.

RESULTS

Among 71 million hospital hospitalizations, we found 177,574 hospitalizations with a principal diagnosis of IBD, with 24,635 (13.9%) for black patients, 124,899 (70.3%) for white patients, and 28,040 (15.8%) were for others. There was no significant difference in inpatient mortality for black vs white patients. Among secondary outcomes, white compared to black patients had increased odds of having a diagnosis of bowel perforation when admitted with a diagnosis of IBD while there was no difference in the odds of developing septic shock. White patients admitted with a diagnosis of UC were also found to have increased total LOS and THC.

CONCLUSION

White patients hospitalized with a principal diagnosis of IBD had no difference in inpatient mortality or septic shock but had worse outcomes such as increased odds of bowel perforation compared to black patients.

摘要

目的

描述按种族分层的住院炎症性肠病(IBD)患者的结局数据十分有限。在这项回顾性队列研究中,我们评估了白人患者和黑人患者因主要诊断为炎症性肠病住院的结局差异。

方法

数据来自 2016 年和 2017 年国家住院患者样本(NIS)数据库。我们的主要结局是住院死亡率,次要结局是住院时间(LOS)、总住院费用(THC)、红细胞(RBC)输血、肠穿孔诊断和严重脓毒症伴感染性休克。我们使用 STATA 软件进行分析。我们使用倾向匹配的多变量回归分析来调整潜在的混杂因素。

结果

在 7100 万次住院中,我们发现有 177574 次因主要诊断为 IBD 住院,其中黑人患者 24635 例(13.9%),白人患者 124899 例(70.3%),其他患者 28040 例(15.8%)。黑人患者与白人患者相比,住院死亡率无显著差异。在次要结局中,与白人患者相比,黑人患者在因 IBD 住院时被诊断为肠穿孔的可能性增加,但发生感染性休克的可能性没有差异。在因 UC 住院的白人患者中,也发现 LOS 和 THC 总费用增加。

结论

白人患者因主要诊断为 IBD 住院,在住院死亡率或感染性休克方面无差异,但与黑人患者相比,结局更差,如肠穿孔的可能性增加。

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