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Racial Differences in Non-variceal Upper Gastrointestinal (GI) Bleeding: A Nationwide Study
Raissa Nana Sede Mbakop1, Arnold N Forlemu2, Chidiebube Ugwu3
1Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
Cureus
|July 10, 2024
Summary
Racial disparities exist in non-variceal upper GI bleeding (NVUGIB) care. African Americans experience delays in esophagogastroduodenoscopy (EGD) and longer hospital stays, while Latinx patients face higher costs.
Area of Science:
- Gastroenterology
- Health Services Research
- Health Disparities
Background:
- Limited understanding of how race influences outcomes in non-variceal upper GI bleeding (NVUGIB).
- Investigating racial differences in NVUGIB etiology and patient outcomes is crucial for equitable healthcare.
- Existing data lacks comprehensive analysis of racial disparities in NVUGIB management and results.
Purpose of the Study:
- To examine racial variations in the causes and consequences of non-variceal upper GI bleeding.
- To identify specific disparities in diagnostic procedures and treatment outcomes among different racial groups.
- To provide data supporting targeted interventions to reduce racial inequities in NVUGIB care.
Main Methods:
- Utilized the Nationwide Inpatient Sample (NIS) database from 2009-2014, a large US inpatient dataset.
- Analyzed International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for NVUGIB, esophagogastroduodenoscopy (EGD), and demographics.
- Compared in-hospital mortality, hospital length of stay (HLOS), total hospital charges, and ICU admission across racial groups using Chi-square tests and Tukey multiple comparisons.
Main Results:
- African Americans and Native Americans showed higher rates of hemorrhagic gastritis/duodenitis and Mallory-Weiss bleeding.
- African Americans were less likely to undergo EGD within 24 hours compared to Whites and Latinxs.
- African Americans experienced longer HLOS and higher ICU admission rates; Latinx and Asian/Pacific Islanders incurred higher total hospital charges.
Conclusions:
- African Americans face barriers to timely EGD and experience prolonged hospitalizations for NVUGIB.
- Latinx patients are disproportionately affected by higher healthcare costs, potentially linked to insurance status.
- Addressing racial disparities in NVUGIB care is essential to improve patient outcomes and reduce healthcare inequities.
Keywords:
nationwide studynon-variceal upper gastrointestinal bleedingracial differencesupper gi bleedusausa: united states of americaMore Related Videos
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