Race affects outcome among infants with intestinal failure

Area of Science:

• Pediatric Gastroenterology
• Transplant Surgery
• Health Disparities Research

Background:

• Intestinal failure (IF) is a critical condition in children, marked by high morbidity and mortality.
• Understanding factors influencing patient outcomes is crucial for improving care.

Purpose of the Study:

• To investigate if racial and ethnic differences impact survival and intestinal transplant (ITx) likelihood in children with IF.
• To identify potential disparities in IF management and outcomes.

Main Methods:

• Analysis of a multicenter cohort study of infants receiving parenteral nutrition (PN) for at least 60 days.
• Outcomes assessed included death and ITx.
• Race categories were simplified to "white" and "nonwhite" for statistical analysis.

Main Results:

• Nonwhite children had a significantly higher 48-month cumulative incidence of death without ITx (0.40 vs. 0.16, P < 0.001).
• Nonwhite children were less likely to receive an ITx (0.07 vs. 0.31, P = 0.003).
• These associations persisted after adjusting for birth weight, diagnosis, and transplant center status.

Conclusions:

• Significant racial disparities exist in both mortality and ITx rates among children with IF.
• The findings underscore the necessity of exploring the underlying causes of these observed outcome differences.
• Addressing racial disparities is essential for equitable care in pediatric intestinal failure.