S868 Racial and Geographic Variations in ICR (Ileo-Colic Resection) Rates Among Hospitalized Patients With Crohn's Disease

Abstract

Introduction: Crohn’s disease patients are at high risk of undergoing abdominal surgeries. Previous studies have demonstrated that there are significant racial and demographic differences in the rates of abdominal surgeries in hospital-admitted IBD patients. Our aim is to determine if there are similar differences in ICR rates among hospitalized CD patients. Methods: We queried the NIS (National inpatient Sample) for the years 2010-2014 for patients hospitalized with CD (ICD-9 555.0-9). Rates of ICR were analyzed based on race, age, gender, geographic location, hospital type, insurance type and Charlson comorbidity index. Individual variables were assessed for their impact using univariate logistic regression and multivariable logistic regression models using STATA 16 software. Results: In univariate analysis, Black and Hispanic patients were both noted to be less likely to undergo ICR compared to non-Hispanic white patients. Additionally, Hispanic patients were found to have the lowest ICR rates, 45% less likely to undergo ICR, while Black patients were 31% less likely to undergo ICR. After adjustment for insurance type, geographical location, comorbidities, and other variables, Black and Hispanic CD patients remained at a significantly lower likelihood to undergo colectomy with hospital teaching status and bed size becoming significant. Age, gender, comorbidity and hospital bed size, hospital type were also significant predictors of ICR rates. Females are 25% less likely to undergo ICR compared to males. There was no significant association between the ICR rates and geographic location. Another important finding is that CD patients in the urban hospital were more likely to undergo ICR than patients in rural hospitals independent of other variables with urban teaching hospitals are almost twice likely than the rural hospital. These associations remained significant in multivariable modeling. The results are presented in Table 1. Conclusion: NIS data indicate that Black and Hispanic patients remain less likely to undergo ICR after adjusting for age, sex, comorbidity, insurance type, and hospital type. Underlying reasons for this persistent disparity remain unclear and warrant additional study.Table 1.: Results of Multicenter Study from the NIS database between 2010-2014.