Su1060 Racial/Ethnic Differences in Inflammatory Bowel Disease Phenotypes At a Tertiary Care Academic Medical Center

Abstract

Background: Inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis (UC) is increasingly recognized in minority patients. Prior studies suggest that African American and Hispanic patients with IBD tend to have more aggressive disease phenotypes compared to non-Hispanic white patients. Aims: To compare the differences in Crohn's disease and UC phenotypes among African American, Hispanic and non-Hispanic white IBD patients at a tertiary care academic medical center. Data and Methods: A list of all inpatient and outpatient visits with attending gastroenterologists and an ICD-9 diagnosis code for IBD (Crohn's disease 555.x; UC 556.x) between 01/2011 and 10/2012 were provided by the Health Information Management Department. Chart review was performed to verify IBD diagnosis and to obtain patient demographics including race/ethnicity, Crohn's disease location and behavior (non-stricturing and non-penetrating vs. stricturing or penetrating), and extent of UC. The chi-square test or Fisher's exact test was used in statistical analysis. Results: There were a total of 502 IBD patients in our study sample, including 86 African Americans (47 Crohn's; 39 UC), 43 Hispanics (23 Crohn's; 20 UC), and 373 non-Hispanic whites (154 Crohn's; 219 UC). For Crohn's disease, there were no significant racial/ethnic difference in disease location (small bowel: African American 64.4%, Hispanic 66.7%, White 70.1%; colon: African American 66.7%, Hispanic 66.7%, White 53.7%), involvement of upper digestive tract (African American 6.7%, Hispanic 9.5%, White 6.1%), disease behavior (stricturing or penetrating: African American 41.3%, Hispanic 52.2%, White 41.7%), or presence of perianal disease (African American 13.3%, Hispanic 23.8%, White 15.0%). For UC, the proportion with extensive colitis was significantly higher among Hispanics (63.2%) and non-Hispanic whites (51.7%) compared to African Americans (29.0%) (both p,0.05). Conclusions: At our tertiary care academic medical center, there was no significant racial/ ethnic difference in Crohn's disease phenotype, but more Hispanic and non-Hispanic white UC patients had extensive colitis compared to African American UC patients. Whether these findings reflect potential referral bias to our IBD center is an important question for future research.