American journal of surgery · 2025
Racial disparities in the management of gallstone pancreatitis: deviations from standard of care.
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Luo William, Portelli Tremont Jaclyn N, Shinde Sachi V, Agala Chris B, Udekwu Pascal Osita, Charles Anthony
Аннотация
OBJECTIVE: To evaluate racial disparities in managing gallstone pancreatitis.
BACKGROUND: Gallstone pancreatitis, responsible for 40 % of U.S. acute pancreatitis cases, has higher mortality than alcohol-induced pancreatitis. The standard care is same-admission cholecystectomy, but prior research links race with reduced odds of receiving this procedure.
METHODS: Using the National Inpatient Sample (2015-2019), we analyzed patients ≥18 diagnosed with gallstone pancreatitis. Race/ethnicity was our primary variable, with same-admission cholecystectomy as the outcome. Propensity scores and inverse probability of treatment weighting adjusted for covariates like age, mortality indices, hospital type, and payor status.
RESULTS: Among 274,215 patients (mean age 58), 62 % received same-admission cholecystectomy; 9.2 % identified as non-Hispanic Black. After propensity score matching, non-Hispanic Black patients were less likely to undergo same-admission cholecystectomy than non-Hispanic White patients (OR 0.84, p < 0.0001).
CONCLUSION: Racial disparities in gallstone pancreatitis care persist, highlighting inequities in access to the standard of care in the U.S.
BACKGROUND: Gallstone pancreatitis, responsible for 40 % of U.S. acute pancreatitis cases, has higher mortality than alcohol-induced pancreatitis. The standard care is same-admission cholecystectomy, but prior research links race with reduced odds of receiving this procedure.
METHODS: Using the National Inpatient Sample (2015-2019), we analyzed patients ≥18 diagnosed with gallstone pancreatitis. Race/ethnicity was our primary variable, with same-admission cholecystectomy as the outcome. Propensity scores and inverse probability of treatment weighting adjusted for covariates like age, mortality indices, hospital type, and payor status.
RESULTS: Among 274,215 patients (mean age 58), 62 % received same-admission cholecystectomy; 9.2 % identified as non-Hispanic Black. After propensity score matching, non-Hispanic Black patients were less likely to undergo same-admission cholecystectomy than non-Hispanic White patients (OR 0.84, p < 0.0001).
CONCLUSION: Racial disparities in gallstone pancreatitis care persist, highlighting inequities in access to the standard of care in the U.S.