Study Finds Racial, Geographic Disparities in US Colectomy Rates

Among patients with ulcerative colitis hospitalized in the United States, racial and geographic disparities persist in colectomy utilization, according to a study published in Inflammatory Bowel Diseases.

“Colectomy is the curative management for ulcerative colitis,” wrote lead author Abhishek Bhurwal, MD, of the Rutgers Robert Wood Johnson School of Medicine, and coauthors in the study background. “Multiple studies have reported racial disparities for colectomy before the advent of anti-TNF alpha agents. The aim of this study was to describe racial and geographic differences in colectomy rates among hospitalized patients with ulcerative colitis after anti-TNF therapy was introduced.”

The analysis included all patients with a primary diagnosis of ulcerative colitis, or complications from ulcerative colitis, who were discharged from the hospital between 2010 and 2014 in a US national cohort.

The overall unadjusted colectomy rate for patients with ulcerative colitis over the study period was 3.90 per 1000 hospitalization days, the study found. Unadjusted colectomy rates were significantly lower for Black patients (2.33) and Hispanic patients (3.99) than for White patients (4.35). Compared with White patients, the incidence rate ratio for colectomy was 0.43 for Black patients after adjustment for confounders.

The study also identified variation in colectomy rates by geographic region, with the highest rates in western regions.

“Further studies are important to determine the social and biologic foundations of these disparities,” researchers advised.

—Jolynn Tumolo

Reference

Bhurwal A, Minacapelli CD, Patel A, et al. Evaluation of a U.S. national cohort to determine utilization in colectomy rates for ulcerative colitis among ethnicities. Inflamm Bowel Dis. 2022;28(1):54-61.