成人鼻衄住院治疗后费用、住院时间和并发症的种族差异。
Racial Disparities in Charges, Length of Stay, and Complications Following Adult Inpatient Epistaxis Treatment.
机构信息
Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey.
Department of Otorhinolaryngology - Head and Neck Surgery, 2013Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York.
出版信息
Am J Rhinol Allergy. 2023 Jan;37(1):51-57. doi: 10.1177/19458924221130880. Epub 2022 Oct 11.
BACKGROUND
Although recent studies have identified an association between race and adverse outcomes in head and neck surgeries, there are limited data examining the impact of racial disparities on adult inpatient outcomes following epistaxis management procedures.
OBJECTIVE
To analyze the association between race and adverse outcomes in hospitalized patients undergoing epistaxis treatment.
METHODS
This retrospective cohort analysis utilized the 2003 to 2014 National Inpatient Sample. codes were used to identify cases with a primary diagnosis of epistaxis that underwent a procedure for epistaxis control. Cases with missing data were excluded. Higher total charges and prolonged length of stay (LOS) were indicated by values greater than the 75th percentile. Demographics, hospital characteristics, Elixhauser comorbidity score, and complications were compared among race cohorts using univariate chi-square analysis and one-way analysis of variance (ANOVA). The independent effect of race on adverse outcomes was analyzed using multivariate binary logistic regression while adjusting for the aforementioned variables.
RESULTS
Of the 83 356 cases of epistaxis included, 80.3% were White, 12.5% Black, and 7.2% Hispanic. Black patients had increased odds of urinary/renal complications (odds ratio [OR] 2.148, 95% confidence interval [CI] 1.797-2.569, < .001) compared to White patients. Additionally, Black patients experienced higher odds of prolonged LOS (OR 1.227, 95% CI 1.101-1.367, < .001) and higher total charges (OR 1.257, 95% CI 1.109-1.426, < .001) compared to White patients. Similarly, Hispanic patients were more likely to experience urinary/renal complications (OR 1.605, 95% CI 1.244-2.071, < .001), higher total charges (OR 1.519, 95% CI 1.302-1.772, < .001), and prolonged LOS (OR 1.157, 95% CI 1.007-1.331, = .040) compared to White patients.
CONCLUSION
Race is an important factor associated with an increased incidence of complications in hospitalized patients treated for epistaxis.
背景
尽管最近的研究已经确定了种族与头颈部手术不良结果之间的关联，但关于种族差异对成人鼻衄管理后住院患者结局影响的数据有限。
目的
分析种族与住院患者接受鼻衄治疗后不良结果之间的关联。
方法
本回顾性队列分析使用了 2003 年至 2014 年全国住院患者样本。使用 代码识别出主要诊断为鼻衄并接受鼻衄控制程序的病例。排除了数据缺失的病例。较高的总费用和较长的住院时间（LOS）表示值大于第 75 百分位数。使用单变量卡方分析和单向方差分析（ANOVA）在种族队列之间比较人口统计学、医院特征、Elixhauser 合并症评分和并发症。在调整上述变量后，使用多元二项逻辑回归分析种族对不良结局的独立影响。
结果
在 83356 例鼻衄病例中，80.3%为白人，12.5%为黑人，7.2%为西班牙裔。与白人患者相比，黑人患者发生泌尿道/肾脏并发症的几率更高（比值比[OR] 2.148，95%置信区间[CI] 1.797-2.569， <.001）。此外，与白人患者相比，黑人患者的 LOS 延长（OR 1.227，95% CI 1.101-1.367， <.001）和总费用更高（OR 1.257，95% CI 1.109-1.426， <.001）的几率更高。同样，与白人患者相比，西班牙裔患者发生泌尿道/肾脏并发症（OR 1.605，95% CI 1.244-2.071， <.001）、总费用更高（OR 1.519，95% CI 1.302-1.772， <.001）和 LOS 延长（OR 1.157，95% CI 1.007-1.331， =.040）的可能性更高。
结论
种族是与住院患者鼻衄治疗后并发症发生率增加相关的重要因素。
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