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Background and Aims <p>To identify demographic predictors, with a focus on race and socioeconomic status, for advanced treatment modality, mortality, and increased length of stay (LOS) in upper gastrointestinal (GI) hemorrhage treatment.</p> Methods <p>Hospitalizations with acute upper GI hemorrhage from 2016 to 2021 were identified in the Healthcare Cost and Utilization Project’s National Inpatient Sample. Cases were divided into interventional radiology (IR) and non-IR (endoscopic) treatments. Statistical analyses calculated significant odds ratios via 95% confidence intervals. The primary outcome of interest was mortality rate. The secondary outcome of interest was the mean LOS. Confounding factors affecting mortality were also examined.</p> Results <p>There was no significant difference in likelihood of an IR procedure or mortality between White patients and both Non-Hispanic (NH) Black and Hispanic patients. NH Black patients had significantly longer LOS in days compared to White patients (12.61 vs 9.57) that persisted when matching for age and sex (13.78 vs 9.92), socioeconomic status (12.94 vs 10.07), chronic comorbidities (11.33 vs 8.88), blood transfusions (14.46 vs 10.21), and vasopressor use (14.43 vs 10.29) (<i>p</i> &lt; 0.001). These LOS differences were not seen under matching conditions post-COVID-19.</p> Conclusion <p>This study presents racial disparities in LOS following acute upper GI hemorrhage, but no differences in advanced treatment utilization or mortality. Confounders were responsible for LOS differences in non-IR treatment, but NH Black patients had persistently longer LOS than White patients after IR treatment.</p>

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Racial Disparities in Upper Gastrointestinal Hemorrhage Treatment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月27日

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  • Riley Scherr,
  • Jacqueline J. Chow,
  • Caitlyn Sing,
  • Katharine A. Kirby,
  • Joseph A. Breuer,
  • Nadine Abi-Jaoudeh

摘要

Background and Aims

To identify demographic predictors, with a focus on race and socioeconomic status, for advanced treatment modality, mortality, and increased length of stay (LOS) in upper gastrointestinal (GI) hemorrhage treatment.

Methods

Hospitalizations with acute upper GI hemorrhage from 2016 to 2021 were identified in the Healthcare Cost and Utilization Project’s National Inpatient Sample. Cases were divided into interventional radiology (IR) and non-IR (endoscopic) treatments. Statistical analyses calculated significant odds ratios via 95% confidence intervals. The primary outcome of interest was mortality rate. The secondary outcome of interest was the mean LOS. Confounding factors affecting mortality were also examined.

Results

There was no significant difference in likelihood of an IR procedure or mortality between White patients and both Non-Hispanic (NH) Black and Hispanic patients. NH Black patients had significantly longer LOS in days compared to White patients (12.61 vs 9.57) that persisted when matching for age and sex (13.78 vs 9.92), socioeconomic status (12.94 vs 10.07), chronic comorbidities (11.33 vs 8.88), blood transfusions (14.46 vs 10.21), and vasopressor use (14.43 vs 10.29) (p < 0.001). These LOS differences were not seen under matching conditions post-COVID-19.

Conclusion

This study presents racial disparities in LOS following acute upper GI hemorrhage, but no differences in advanced treatment utilization or mortality. Confounders were responsible for LOS differences in non-IR treatment, but NH Black patients had persistently longer LOS than White patients after IR treatment.