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

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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.

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Authors and Affiliations

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

    Jennifer C. Asotibe, Emmanuel Akuna, Dimeji Williams, Ehizogie Edigin, Ikechukwu Achebe & William Trick

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

    Olukayode A. Busari

  3. University of Calabar College of Medical Sciences, PMB 1115, Calabar Municipal, Nigeria

    Brenda Mishael Asotibe

  4. Department of Gastroenterology, John H Stroger Hospital of Cook County, Chicago, IL, 60612, USA

    Satya Mishra

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  1. Jennifer C. Asotibe
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  2. Emmanuel Akuna
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Contributions

Jennifer C Asotibe MD and Emmanuel Akuna MD are credited with the conception of the study, design of the study, acquisition of data, interpretation of the data, revision of intellectual content, and final approval of the submitted version of the manuscript. Dimeji Williams MD, Olukayode A Busari MD, and Ehizogie Edigin MD are credited with the drafting of the manuscript, interpretation of the data, discussion of relevant data, and extensive literature review. Ikechukwu Achebe MD and Brenda Mishael Asotibe MD are credited with the literature review and revision of intellectual content for the manuscript. Williams Trick MD and Satya Mishra MD are credited with literature review, critical revision of the manuscript, and approval of final submitted manuscript.

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Correspondence to Jennifer C. Asotibe.

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Asotibe, J.C., Akuna, E., Williams, D. et al. Racial differences in the outcomes of IBD hospitalizations: a national population-based study. Int J Colorectal Dis 37, 221–229 (2022). https://doi.org/10.1007/s00384-021-04052-z

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