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Abstract：
Background and aims Knowledge about the impact of race on non-variceal upper GI bleeding (NVUGIB) is limited. This study explored the racial differences in the etiology and outcome of NVUGIB. Methods We conducted a study from 2009 to 2014 using the Nationwide Inpatient Sample (NIS) database. NIS is the largest publicly available all-payer inpatient database in the USA with more than seven million hospital stays each year. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for NVUGIB, esophagogastroduodenoscopy (EGD) and demographics were obtained. The outcomes of interest were in-hospital mortality, hospital length of stay (HLOS), total hospital charges, admission to the intensive care unit (ICU), and patient disposition. Analysis was conducted using Chi-square tests and Tukey multiple comparisons between groups. Results Among 1,082,516 patients with NVUGIB, African American and Native Americans had the highest proportions of hemorrhagic gastritis/duodenitis (8.2% and 4.2%, respectively) and Mallory-Weiss bleeding (10.4% and 5.4%, respectively; p<0.01). African Americans were less likely to get an EGD done within 24 hours of admission compared to Whites and Latinxs (45.9% vs 50.1% and 50.4%, respectively; p<0.001). In-hospital mortality was similar among African Americans, Latinxs, and Whites (5.8% vs 5.6% vs 5.9%, respectively; p=0.175). Asian/Pacific Islanders and African Americans were more likely to be admitted to the ICU (9.6% and 9.0%, respectively; p<0.001). Moreover, African Americans had a longer HLOS compared to Latinxs and Whites (7.5 vs 6.5 and 6.4 days, respectively; p<0.001). Conversely, Asian/Pacific Islanders and Latinx incurred the highest hospital total charges compared to African Americans and Whites ($81,821 and $69,267 vs $61,484 and $53,767, respectively; p<0.001). Conclusion African Americans are less likely to receive EGD within 24 hours of admission and are more likely to be admitted to the ICU with prolonged hospital lengths of stay. Latinxs are more likely to be uninsured and incur the highest hospital costs.
摘要：
背景和目的关于种族对非静脉曲张性上消化道出血（NVUGIB）的影响的知识是有限的。本研究探讨了NVUGIB的病因和结局的种族差异。方法我们于2009年至2014年使用全国住院患者样本（NIS）数据库进行了一项研究。NIS是美国最大的公开所有付款人住院数据库，每年住院时间超过700万。国际疾病分类，第九次修订,NVUGIB的临床修改(ICD-9-CM)代码，获得了食管胃十二指肠镜检查（EGD）和人口统计学。感兴趣的结果是住院死亡率，住院时间（HLOS），医院总费用,入住重症监护病房(ICU)，和病人的性格。组间使用卡方检验和Tukey多重比较进行分析。结果1,082,516例NVUGIB患者中,非裔美国人和美洲原住民的出血性胃炎/十二指肠炎比例最高（8.2％和4.2％，分别）和Mallory-Weiss出血（10.4%和5.4%，分别为；p<0.01)。与白人和拉丁人相比，非裔美国人在入院后24小时内完成EGD的可能性较小（45.9%对50.1%和50.4%，分别为；p<0.001)。非洲裔美国人的住院死亡率相似，拉丁裔,和白人（5.8%对5.6%对5.9%，分别为；p=0.175)。亚洲/太平洋岛民和非洲裔美国人更有可能进入ICU（9.6％和9.0％，分别为；p<0.001)。此外，与拉丁裔和白人相比，非裔美国人的HLOS更长（7.5天，6.5天和6.4天，分别为；p<0.001)。相反，与非裔美国人和白人相比，亚洲/太平洋岛民和拉丁裔人的医院总费用最高（分别为81,821美元和69,267美元，而61,484美元和53,767美元；p<0.001）。结论非裔美国人在入院后24小时内接受EGD的可能性较小，而住院时间延长则更有可能进入ICU。拉丁裔更有可能没有保险，并承担最高的医院费用。
