Clinical Outcomes of African American Patients With Crohn's Disease: A Population-Based Study
Background:
Crohn’s disease is a type of chronic inflammatory bowel disease (IBD), characterized by transmural inflammation of both small and large bowel, leading to persistent abdominal pain, diarrhea, and other potential complications. The US population is diverse in racial Background. There is limited data specifically for patients with Crohn’s disease who are of African American race. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these patients.
Methods:
Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS searched for hospitalizations of adult Crohn’s disease patients who are African American versus those of other racial Backgrounds using the <italic>International Classification of Diseases Tenth Revision</italic> codes. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. SPSS software was used for statistical analysis.
Results:
This study included 74,743 with Crohn’s disease of which 9,172 (12.3%) patients were African American. Patients who were of African American race had a higher prevalence of CKD (16.00% Vs 14.00%, <italic>P<</italic> 0.001), and hypertension (18.50% Vs 17.00%, <italic>P<</italic> 0.001). However, they were less likely to smoke (17.00% Vs 21.82%, <italic>P<</italic> 0.001). Multivariate regression showed that African American patients with Crohn’s disease had higher inpatient mortality (OR 1.112, CI 1.091-1.133, <italic>P<</italic> 0.001). On secondary analysis, it has shown that African-American patients with Crohn’s disease had higher odds of having anemia (OR 1.182, CI 1.176-1.187, <italic>P<</italic> 0.001), AKI (OR 1.152, CI 1.144-1.160, <italic>P<</italic> 0.001), pericarditis (OR 1.157, CI 1.113-1.202, <italic>P<</italic> 0.001), esophageal ulcer (OR 1.114, CI 1.076-1.153 <italic>P<</italic> 0.001), coagulopathy (OR 1.111, CI 1.098-1.125, <italic>P<</italic> 0.001), pulmonary embolism (OR 1.151, CI 1.137-1.166, <italic>P<</italic> 0.001), and acute hepatitis (OR 1.549, 1.482-1.621, <italic>P<</italic> 0.001).
Conclusions:
In this nationally representative population-based retrospective cohort study, African American race was associated with higher mortality and worse outcomes among patients who are diagnosed with Crohn’s disease.
