Racial Disparities in Charges, Length of Stay, and Complications Following Adult Inpatient Epistaxis Treatment

Abstract

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. International Classification of Diseases, Ninth Revision 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, P < .001) compared to White patients. Additionally, Black patients experienced higher odds of prolonged LOS (OR 1.227, 95% CI 1.101-1.367, P < .001) and higher total charges (OR 1.257, 95% CI 1.109-1.426, P < .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, P < .001), higher total charges (OR 1.519, 95% CI 1.302-1.772, P < .001), and prolonged LOS (OR 1.157, 95% CI 1.007-1.331, P = .040) compared to White patients. Conclusion Race is an important factor associated with an increased incidence of complications in hospitalized patients treated for epistaxis.

Healthcare Disparities in Otolaryngology

“…Patients with AFRS were more likely to be residing in counties with higher poverty level, lower income level, and higher number of African American individuals than CRS [ 83 ]. Patients who identified as Black or Hispanic and were hospitalized for epistaxis had increased incidence of complications, longer length of stay, and consequently higher hospital charges compared to White patients [ 84 ].…”

Advancing Rhinology Through Research

“…A particular opportunity to advance the field lies within improving our limited understanding of how sociodemographic factors impact sinonasal disease and treatment response. In this issue, Randhawa et al 1 used the National Inpatient Sample to evaluate the association of race and ethnicity with adverse outcomes in hospitalized patients who had procedural epistaxis treatment. In this study of over 83,000 cases of procedural epistaxis treatment, Black and Hispanic patients were more likely to have urinary or renal complications, prolonged length of hospital stay, and higher overall charges as compared to their White non-Hispanic counterparts.…”