Racial Disparity in Colectomy Rates Among Patients with UC

A recent study found that the rate of colectomy rates for hospitalized African-American and Hispanic patients with ulcerative colitis (UC) was lower than that of White patients.

While multiple studies have reported on racial disparities for colectomy before the advent of anti-TNF alpha agents, the researchers of this study aimed to determine whether racial and geographic disparities in colectomy rates among hospitalized patients with UC persisted after anti-TNF therapy was introduced.

Researchers analyzed a national database to investigate all patients discharged from the hospital between 2010 and 2015 with a primary diagnosis of UC or of complications of UC.

The unadjusted national colectomy rate among hospitalized patients with UC between 2010 and 2014 was 3.90 per 1000 hospitalization days (95% confidence interval, 3.72-4.08), the authors wrote. However, they noted, “the unadjusted colectomy rates in African American (2.33 vs 4.35; P < 0.001) and Hispanic patients (3.99 vs 4.35; P ≤ 0.009) were considerably lower than those for White patients. After adjustment for confounders, the incidence rate ratio for African American as compared to White patients was 0.43 (95% confidence interval, 0.32-0.58; P < 0.001).” There was significant variation in colectomy rates by geographic region of the US, with western regions having the highest rates (4.76 vs 3.20; P < 0.001).

This study shows that racial and geographical disparities still exist for the rate of colectomy among patients hospitalized patients with UC. The authors stated that further studies will be important to determine social and biological foundations for these disparities.

—Allison Casey

Reference:
Bhurwal A, Minacapelli CD, Patel A, et al. Evaluation of a US national cohort to determine utilization in colectomy rates for ulcerative colitis among ethnicities. Inflamm Bowel Dis. 2022; 28(1):54–61. doi: 10.1093/ibd/izab020