P2290 - Racial Disparities in All-Cause Inpatient Endoscopic Retrograde Cholangiopancreatography in the United States: How Important Is Race?

Dushyant Singh. Dahiya, MD¹, Ramaswamy Sundararajan, MBBS², Saurabh Chandan, MD³, Manesh Kumar Gangwani, MD⁴, Muhammad Aziz, MD⁵, Andrew Canakis, DO⁶, Daryl Ramai, MD⁷, Jay Bapaye, MBBS, MD⁸, Babu Mohan, MD, MS⁹, Amandeep Singh, MD¹⁰, Chin-I Cheng, PhD¹¹, Sumant Inamdar, MD¹², Madhusudhan R.. Sanaka, MD¹⁰, Neil Sharma, MD¹³, Mohammad Al-Haddad, MD^14
1University of Kansas School of Medicine, Kansas City, KS; ²Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; ³Creighton University School of Medicine, Omaha, NE; ⁴University of Toledo Medical Center, Toledo, OH; ⁵University of Toledo, Toledo, OH; ⁶University of Maryland School of Medicine, Baltimore, MD; ⁷University of Utah School of Medicine, Salt Lake City, UT; ⁸Rochester General Hospital, Rochester, NY; ⁹University of Utah Health School of Medicine, Salt Lake City, UT; ¹⁰Cleveland Clinic Foundation, Cleveland, OH; ¹¹Central Michigan University, Mount Pleasant, MI; ¹²University of Arkansas, Toledo, OH; ¹³Parkview Health, Fort Wayne, IN; ¹⁴Indiana University, Indianapolis, IN

Introduction: Endoscopic Retrograde Cholangiopancreatography (ERCP) has evolved into a vital endoscopic technique for managing numerous pancreaticobiliary disorders. Studies have reported higher rates of adverse outcomes and post-ERCP complications in ethnic minorities, making race an important risk factor for ERCP utilization. In this study, we aimed to identify the influence of race on clinical outcomes of all-cause inpatient ERCPs in the United States (US).

Methods: We used the National Inpatient Sample (NIS) to identify all adult (≥18 years) hospitalizations that underwent ERCP in the US from 2007–2019. The study population was further subdivided into 3 groups based on race (Whites, Blacks, and Hispanics). Hospitalization characteristics and clinical outcomes were highlighted and compared. p-values ≤0.05 were considered statistically significant.

Results: Between 2007–2019, there were 1,515,516 White, 205,338 Black and 348,269 Hispanic hospitalizations that underwent inpatient ERCP in the US. Whites had a higher mean age (62.5 vs 54.8 vs 50.7 years, p< 0.0001) and higher proportion of patients ≥65 years of age compared to Blacks and Hispanics, respectively. Overall, a female predominance was noted for all-cause inpatient ERCPs (Table 1).

The household income for a higher proportion of Blacks and Hispanics was in the first (low-income) Quartile, while most White hospitalizations had household incomes in the second, third and fourth Quartiles (Table 1). A higher proportion of Black hospitalizations that underwent inpatient ERCP had a higher Charlson Comorbidity Index (CCI) ≥3 (32.37% vs 26.76% vs 18.36%, p< 0.0001) compared to Whites and Hispanics, respectively.

All-cause inpatient mortality (2.03% vs 1.51% vs 0.99%, p< 0.0001) and longer mean length of stay [LOS] (7.62 vs 6.23 vs 6.04 days, p< 0.0001) was higher for Black hospitalizations that underwent inpatient ERCPs compared to Whites and Hispanics, respectively. However, Hispanic hospitalizations had the highest mean total healthcare charge at $80,569 (Table 1).

Discussion: Our study demonstrates the influence of race on hospitalization characteristics and clinical outcomes for hospitalizations that underwent inpatient ERCP. Black hospitalizations had a significant comorbidity burden, higher all-cause inpatient mortality, and longer mean LOS. Ethnic minorities i.e. Hispanics and Blacks also had a higher total healthcare charge compare to White hospitalizations. There is an urgent need for large, prospective studies to investigate these findings.


Disclosures:


Dushyant Singh. Dahiya, MD¹, Ramaswamy Sundararajan, MBBS², Saurabh Chandan, MD³, Manesh Kumar Gangwani, MD⁴, Muhammad Aziz, MD⁵, Andrew Canakis, DO⁶, Daryl Ramai, MD⁷, Jay Bapaye, MBBS, MD⁸, Babu Mohan, MD, MS⁹, Amandeep Singh, MD¹⁰, Chin-I Cheng, PhD¹¹, Sumant Inamdar, MD¹², Madhusudhan R.. Sanaka, MD¹⁰, Neil Sharma, MD¹³, Mohammad Al-Haddad, MD¹⁴. P2290 - Racial Disparities in All-Cause Inpatient Endoscopic Retrograde Cholangiopancreatography in the United States: How Important Is Race?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.