Racial Disparities in Rates of Therapeutic Intervention During Hospitalizations for Acute Cholangitis: A National Survey

Patel, Neel; Hashemipour, Reza; Ahlawat, Sushil

doi:10.14309/00000434-201810001-00767

Cited by 3 publications

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“…10,11 These studies found that non-White patients hospitalized for acute cholangitis had higher mortality rates, prolonged hospital LOS, and incurred higher health care costs for acute cholangitis. 10 Black patients, in particular, had higher mortality rates and were less likely to undergo biliary drainage than White patients. 11 Since the publication of these studies, the Tokyo Guidelines have been released and updated twice, providing guidance on the diagnosis and management of patients with acute cholangitis.…”

Section: Resultsmentioning

confidence: 99%

“…Several older studies have documented evidence of racial and ethnic disparities among patients hospitalized with acute cholangitis 10,11 . These studies found that non-White patients hospitalized for acute cholangitis had higher mortality rates, prolonged hospital LOS, and incurred higher health care costs for acute cholangitis 10 . Black patients, in particular, had higher mortality rates and were less likely to undergo biliary drainage than White patients 11 .…”

Section: Discussionmentioning

confidence: 99%

“…There are well-documented racial differences in the incidence of gallstone-related disease and acute cholangitis 2 . In addition, studies from before the publication of the Tokyo Guidelines documented evidence of racial and ethnic disparities among outcomes for patients hospitalized with acute cholangitis 10,11 . Despite recognition of these disparities in the literature, the Tokyo Guidelines did not specifically address racial/ethnic considerations in the management of cholangitis 1,12 .…”

mentioning

confidence: 99%

“…2 In addition, studies from before the publication of the Tokyo Guidelines documented evidence of racial and ethnic disparities among outcomes for patients hospitalized with acute cholangitis. 10,11 Despite recognition of these disparities in the literature, the Tokyo Guidelines did not specifically address racial/ethnic considerations in the management of cholangitis. 1,12 Of particular concern is the Tokyo Guideline's focus on early ERCP for optimal management of acute cholangitis.…”

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confidence: 99%

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Racial and Ethnic Disparities Among Patients Hospitalized for Acute Cholangitis in the United States

Wang¹,

Wadhwani

Cullaro

et al. 2022

Journal of Clinical Gastroenterology

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Goals: We sought to determine whether race/ethnicity is associated with hospitalization outcomes among patients admitted with acute cholangitis. Background: Few studies have evaluated the association between race and outcomes in patients with acute cholangitis. Study: We analyzed United States hospitalizations from 2009 to 2018 using the Nationwide Inpatient Sample (NIS). We included patients 18 years old or above admitted with an ICD9/10 diagnosis of cholangitis. Race/ethnicity was categorized as White, Black, Hispanic, or Other. We used multivariable regression to determine the association between race/ethnicity and in-hospital outcomes of interest, including endoscopic retrograde cholangiopancreatography (ERCP), early ERCP (<48 h from admission), length of stay (LOS), and in-hospital mortality. Results: Of 116,889 hospitalizations for acute cholangitis, 70% identified as White, 10% identified as Black, 11% identified as Hispanic, and 9% identified as Other. The proportion of non-White patients increased over time. On multivariate analysis controlling for clinical and sociodemographic variables, compared with White patients, Black patients had higher in-hospital mortality (adjusted odds ratio: 1.4, 95% confidence interval: 1.2-1.6, P<0.001). Black patients were also less likely to undergo ERCP, more likely to undergo delayed ERCP, and had longer LOS (P<0.001 for all). Conclusions: In this contemporary cohort of hospitalized patients with cholangitis, Black race was independently associated with fewer and delayed ERCP procedures, longer LOS, and higher mortality rates. Future studies with more granular social determinants of health data should further explore the underlying reasons for these disparities to develop interventions aimed at reducing racial disparities in outcomes among patients with acute cholangitis.

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confidence: 99%

Section: Discussionmentioning

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Racial and Ethnic Disparities Among Patients Hospitalized for Acute Cholangitis in the United States

Wang¹,

Wadhwani

Cullaro

et al. 2022

Journal of Clinical Gastroenterology

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“…Before the ICD coding change, trends were obtained uniformly by the ICD-9 coding system and represent true hospitalization rate variations. Limited available literature described ethnic AC incidence as a percentage among all AC patients, but these represent raw numbers [ 13 , 14 ]. The total population at risk is an essential parameter of incidence estimation, and we calculated the hospitalization rate per 100,000 persons of each race, which delineates the racial disease distribution more precisely.…”

Section: Discussionmentioning

confidence: 99%

Racial differences in hospitalizations for acute cholangitis: a nationwide time trend analysis, 2008-2018

Farooq

Tarar

Franco

et al. 2022

aog

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Background The data on racial epidemiologic trends for acute cholangitis (AC) are scarce. Therefore, we conducted a longitudinal assessment of the racial breakdown of AC-related hospitalizations in the United States (US) over 11 years (2008-2018). Methods Using the National Inpatient Sample, we retrieved adult (>18 years) patients with AC. The adjusted yearly hospitalization rate per 100,000 for each race category was calculated based on the US population estimate for July 1 of the corresponding year obtained from the US Census Bureau. We followed Healthcare Cost and Utilization Project recommendations to: (1) derive a time-interrupted trend (before and after 2015), after determining that the International Classification of Diseases coding change affected AC hospitalizations because of more specific coding in the tenth revision; and (2) generate proportionate estimates using revised trend weights. Results A total of 321,849 patients with AC were included in the analysis. Before 2015, the overall hospitalizations (per 100,000 persons) increased from 16.03 in 2008 to 20.76 in 2014 (P<0.001). Following 2015, the overall hospitalizations increased from 14.34 in 2016 to 14.70 in 2018 (P=0.04). After Whites, Asians represented the ethnic group with the highest race-specific AC hospitalizations per 100,000 persons. Conclusions This cohort study demonstrated an overall rising and disproportionate rate among different races for AC-related hospitalizations. Even though Asians constitute only 6.5% of the US population, they represent the ethnic minority with most hospitalizations for AC.

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Leveraging a New ICD-10 Diagnosis Code to Characterize Hospitalized Patients With Primary Sclerosing Cholangitis

Wang

Auerbach²,

Oreper³

et al. 2023

Clinical Gastroenterology and Hepatology

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Racial Disparities in Rates of Therapeutic Intervention During Hospitalizations for Acute Cholangitis: A National Survey

Cited by 3 publications

References 0 publications

Racial and Ethnic Disparities Among Patients Hospitalized for Acute Cholangitis in the United States

Racial and Ethnic Disparities Among Patients Hospitalized for Acute Cholangitis in the United States

Racial differences in hospitalizations for acute cholangitis: a nationwide time trend analysis, 2008-2018

Leveraging a New ICD-10 Diagnosis Code to Characterize Hospitalized Patients With Primary Sclerosing Cholangitis

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