S896 Clinical Manifestations of Crohn’s Disease in African Americans in a Rural versus Urban Setting

Abstract

Introduction: The incidence of inflammatory bowel disease (IBD), both Crohn’s Disease (CD) and Ulcerative Colitis (UC), has dramatically increased in the black population in recent years. While studies have focused on genetics and environmental factors contributing to the rise in incidence, no documented studies currently exist investigating the disease presentation utilizing a large cohort of black IBD patients, particularly those located in rural and urban settings, where this rise in incidence is realized the most. This study aims to better characterize the clinical characteristics of Crohn’s Disease in black populations, including its presentation and intra- and extraintestinal and manifestations in order to better understand this rise in incidence and guide treatment parameters in the future to address this. Methods: We performed a multicenter retrospective review of black patients from both a large urban center and a rural IBD center. Patients were identified utilizing ICD-10 diagnostic codes in the electronic medical records. The clinical manifestation of disease, disease extent and severity, laboratory values were abstracted via gastroenterology clinic and colonoscopy documentation. We include only patients who self-identified as African Americans or Black in ethnicity/race. A sample of CD patients seen in clinic or who underwent colonoscopy from 2018 to 2020 were manually extracted and reviewed in the urban center. Data on rural patients from 2011-2019 was electronically exported from electronic medical records, after which random sample of 100 patients was manually reviewed for accuracy. Statistical calculations were conducted via T-test, Chi Squared, and Fisher’s Exact test. Results: A total of 428 AA CD patients were included, 300 in the rural setting, 128 in the urban setting. The rural CD patients were significantly younger, with a female predominance, while the prevalence of severe disease phenotypes was comparable between the two groups, as shown in Table 1. For extra-intestinal manifestations of IBD, there was a higher prevalence of fatty liver disease in the rural population, while the remaining EIMs were similar (Table 1). Conclusion: The younger age of presentation and female predominance of CD in AAs have not been previously reported. Our study highlighted the importance of more research efforts to include minority CD patients from rural populations.Table 1.: Baseline Patient Characteristics.