溃疡性结肠炎患者回肠袋-肛门吻合术应用的民族差异趋势。

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY
Crohn's & Colitis 360 Pub Date : 2023-11-16 eCollection Date: 2023-10-01 DOI:10.1093/crocol/otad072
Jana G Hashash, Fadi H Mourad, Tarek Odah, Francis A Farraye, Paul Kroner, Luca Stocchi
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引用次数: 0

摘要

背景:大约15%-20%的溃疡性结肠炎(UC)患者在其一生中需要手术治疗。回肠袋-肛门吻合术(IPAA)是首选的手术选择,通常需要有炎症性肠病(IBD)手术经验的专家。方法:本研究的目的是评估IPAA在不同种族/民族人群中治疗UC的比较使用情况,并观察美国过去十年的趋势,以及对各自术后结果的比较评估。这是一项使用2009-2018年国家住院患者样本(NIS)数据集的观察性回顾性研究。所有UC编码为ICD-9/10CM的患者均被纳入。主要结局是比较过去十年不同种族/民族间IPAA构建的趋势,并与白人患者进行比较作为参考。采用多元回归分析调整年龄、性别、Charlson合并症指数、患者邮政编码收入、保险状况、医院区域、位置、规模和教学状况。结果:在2009年至2018年期间,美国医院因UC相关诊断出院的患者数量有所增加,但在此期间接受IPAA的患者数量有所减少。在1 153 363例与UC相关的入院患者中,60 688例需要手术治疗UC,其中16 601例在研究期间接受了IPAA治疗。在所有接受UC手术的患者中,2862例(4.7%)为黑人,44351例为白人。该分析表明,与白人相比,黑人患者在2009年和2018年都不太可能接受IPAA治疗。与白人相比,西班牙裔患者在2009年接受IPAA的可能性明显较低,但在2018年接受IPAA的可能性不再较低。结论:与白人患者相比,需要UC手术的黑人患者使用IPAA的情况较少。需要进一步的研究来确定种族差异是否是获得专业护理机会减少的一个因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ethnic Variation Trends in the Use of Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis.

Background: Approximately 15%-20% of patients with ulcerative colitis (UC) will require surgery during their lifetime. Ileal pouch-anal anastomosis (IPAA) is the preferred surgical option, which typically requires access to a specialist experienced in surgery for inflammatory bowel diseases (IBD).

Methods: The aims of this study are the assessment of the comparative use of IPAA for UC among different racial/ethnic groups and observe trends over the past decade in the United States as well as the comparative assessment of their respective postoperative outcomes. This was an observational retrospective study using the National Inpatient Sample (NIS) 2009-2018 dataset. All patients with ICD-9/10CM codes for UC were included. The primary outcome was comparative trends in IPAA construction across races/ethnicities in the past decade, which was compared to White patients as reference. Multivariate regression analyses were used to adjust for age, gender, Charlson comorbidity index, income in patient zip code, insurance status, hospital region, location, size, and teaching status.

Results: The number of patients discharged from US hospitals with an associated diagnosis of UC increased between 2009 and 2018, but the number of patients undergoing an IPAA decreased during that time period. Of 1 153 363 admissions related to UC, 60 688 required surgery for UC, of whom 16 601 underwent IPAA in the study period. Of all the patients undergoing surgery for UC, 2862 (4.7%) were Black, while 44 351 were White. This analysis indicated that Black patients were less likely to undergo IPAA both in 2009 and in 2018 compared to Whites. Hispanic patients were significantly less likely to receive IPAA in 2009 but were no longer less likely to receive IPAA in 2018 when compared to Whites.

Conclusions: The use of IPAA among Black patients requiring surgery for UC remains less common than amongst their White counterparts. Further research is needed to determine if racial disparity is a factor in decreased access to specialized care.

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来源期刊
Crohn's & Colitis 360
Crohn's & Colitis 360 Medicine-Gastroenterology
CiteScore
2.50
自引率
0.00%
发文量
41
审稿时长
12 weeks
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