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影响镰状细胞贫血患者入院、处置及医院结局的种族不平等:来自国家住院样本数据库的见解

Racial Inequities Influencing Admission, Disposition and Hospital Outcomes for Sickle Cell Anemia Patients: Insights from the National Inpatient Sample Database.

作者信息

Jayakumar Jayalekshmi, Vojjala Nikhil, Ginjupalli Manasa, Khan Fiqe, Ayyazuddin Meher, Turku Davin, Babu Kalaivani, Rajarajan Srinishant, Bhanushali Charmi, Mathew Tijin Ann, Ramadas Poornima, Krishnamoorty Geeta

机构信息

The Brooklyn Hospital Centre, Brooklyn, NY 11201, USA.

Trinity Health Oakland, Detroit, MI 48341, USA.

出版信息

Hematol Rep. 2025 May 9;17(3):27. doi: 10.3390/hematolrep17030027.

Abstract

Sickle cell disease (SCD) significantly impacts diverse racial groups, particularly African American and Hispanic persons, who experience notable disparities in healthcare outcomes. Despite the extensive literature on SCD, studies focusing on in-hospital racial inequities remain limited. We conducted a retrospective analysis using the National Inpatient Sample (NIS) from 2016 to 2020, identifying adult hospitalizations for SCD (HbSS genotype). Hospitalizations were categorized by race-White, African American, Hispanic, and other, and analyzed for demographic variables, admission types, disposition outcomes, and complications. Statistical analyses included chi-square tests and multivariate logistic regression, adjusting for confounders. Of the 1,089,270 identified hospitalizations, 90.31% were African American. African American and Hispanic patients exhibited significantly higher non-elective admissions compared to Whites (77.81%). In-hospital mortality was highest among Hispanics (0.82%). Multivariate regression analysis revealed that African Americans and others had higher odds of prolonged hospital stays (Adjusted Odds Ratio (AOR): 1.30 and 1.20, respectively). African Americans and Hispanics also had increased risks of in-hospital complications of SCD. This study highlights substantial racial disparities in SCD hospitalizations, with African Americans and Hispanics facing poorer outcomes compared to Whites. Hispanics also demonstrated increased mortality. These findings underscore the need for targeted healthcare interventions to address racial inequities in SCD management and improve outcomes for all affected populations.

摘要

镰状细胞病(SCD)对不同种族群体有显著影响,尤其是非裔美国人和西班牙裔,他们在医疗保健结果方面存在明显差异。尽管有大量关于SCD的文献,但关注住院期间种族不平等的研究仍然有限。我们使用2016年至2020年的全国住院样本(NIS)进行了一项回顾性分析,确定了成人SCD(HbSS基因型)住院病例。住院病例按种族分类为白人、非裔美国人、西班牙裔和其他种族,并分析了人口统计学变量、入院类型、出院结局和并发症。统计分析包括卡方检验和多变量逻辑回归,并对混杂因素进行了调整。在1089270例确定的住院病例中,90.31%是非裔美国人。与白人相比,非裔美国人和西班牙裔患者的非择期入院率显著更高(77.81%)。西班牙裔患者的住院死亡率最高(0.82%)。多变量回归分析显示,非裔美国人和其他种族的患者住院时间延长的几率更高(调整后的优势比(AOR)分别为1.30和1.20)。非裔美国人和西班牙裔患者发生SCD住院并发症的风险也增加。这项研究突出了SCD住院病例中存在的重大种族差异,与白人相比,非裔美国人和西班牙裔面临更差的结局。西班牙裔的死亡率也有所上升。这些发现强调了需要有针对性的医疗干预措施,以解决SCD管理中的种族不平等问题,并改善所有受影响人群的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165e/12101344/b7011d029199/hematolrep-17-00027-g001.jpg

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