B0173 - African Americans Have Higher Inpatient Mortality at a Younger Age: A Nationwide Inpatient Sample Database Analysis

Pranav D. Patel, MD¹, Yash Shah, MD², Deepa P. Budh, MD³, Dhruvan Patel, MD⁴, Benyam Addissie, MD^5
1Geisinger Medical Center, Danville, PA; ²Hackensack Meridian Ocean Medical Center, Brick, NJ; ³St. Barnabas Health System, Bronx, NY; ⁴Mercey Fitzgerald Hospital, Darby, PA; ⁵Geisinger Health System, Danville, PA

Introduction: Colorectal cancer (CRC) is the 3rd most common cause of cancer-related death in women and 2nd in men in the US. CRC incidence and mortality have been trending down with better screening strategies. Significant disparities are still reported to remain among certain races/ethnicities and age groups. In this study, we assessed CRC-related outcomes in African Americans (AA) as compared to Caucasians to understand racial and age disparities.

Methods: We used the Nationwide Inpatient Sample (NIS) database from 2008 and 2019. Previously validated ICD-10-CM codes identified CRC. CRC patients were divided into two groups Caucasians and AA. Univariate logistic regression for categorical variables and linear regression for continuous variables was carried out to identify independent associations at p < 0.05. Statistical Analysis was performed using R studio. Age of hospitalization and racial distribution was studied along with the other comorbidities.

Results: A total of 2,569,516 inpatient admissions were included. 410,139 were AA and 2,159,377 were Caucasians (Table.1). AA’s have a younger age at admission with a mean age of 63 years compared to 68 years in Caucasians (p< 0.001). AA’s have a higher percentage of inpatient admissions in the younger population between the ages of 28 to 67. Caucasians have a higher percentage of inpatient admission due to CRC after 68 years of age. Despite their relatively younger age, AA’s have significantly higher inpatient mortality (5.9%) compared to Caucasians (4.9%) (p< 0.001). More AA’s (51%) had low median household income of $1-24999 in contrast to Caucasians (23%). AA’s have a higher percentage of use of Medicaid (18% vs. 6.7%) and Caucasians have a higher percentage of Medicare (59% vs 49%). The disparity in mortality remained significantly higher in the AA population compared to Caucasians even after controlling household income and type of insurance.

Discussion: Despite advances in CRC screening and treatment, racial disparities in outcomes continue to exist. This study found that AA’s with colorectal cancer have consistently higher inpatient mortality rates compared to Caucasians with a widening gap from 2015 to 2019 (figure 1). AA’s with colorectal cancer are also being hospitalized at younger ages compared to their Caucasian counterparts. These disparities are most likely due to a number of social determinants of health. Future screening and treatment guidelines need to recognize these factors in order to improve equity in colorectal cancer outcomes.




Disclosures:


Pranav D. Patel, MD¹, Yash Shah, MD², Deepa P. Budh, MD³, Dhruvan Patel, MD⁴, Benyam Addissie, MD⁵. B0173 - African Americans Have Higher Inpatient Mortality at a Younger Age: A Nationwide Inpatient Sample Database Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.