Race/Ethnicity-Specific Disparities in the Severity of Disease at Presentation in Adults with Ulcerative Colitis: A Cross-Sectional Study
Race/Ethnicity-Specific Disparities in the Severity of Disease at Presentation in Adults with Ulcerative Colitis: A Cross-Sectional Study
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DOI：
10.1007/s10620-017-4733-5
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发表时间：
2017-10-01
影响因子：
3.1
通讯作者：
Wong, Robert J.
中科院分区：
文献类型：
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作者：
Castaneda, Garland;Liu, Benny;Wong, Robert J.
虽然溃疡性结肠炎 (UC) 在白种人群体中得到了充分研究，但关于少数种族/族裔 UC 患者的数据较少，包括就诊时疾病严重程度的差异。为了评估多种族服务不足人群中 UC 疾病表现的种族/族裔特异性差异。我们对 2014 年 7 月至 2014 年 7 月至 2016 年 5 月，比较就诊时疾病严重程度的种族/民族特异性差异。使用基于临床医生的简单临床结肠炎活动指数 (SCCAI) 和就诊时的 Mayo 评分来评估严重程度。使用多变量有序逻辑回归模型评估与 SCCAI 和 Mayo 评分的关联。 在 98 名 UC 患者中（56.1% 男性，平均年龄 40.1 (SD 14.2)），32.0% 为非裔美国人，26.7% 西班牙裔，16.0% 亚洲人和 20.0% 白种人。平均 Mayo 评分为 6.6，平均 SCCAI 评分为 6.5。分层 种族/民族方面，非白种人的 SCCAI 得分显着高于白种人（7.0 vs 4.6，p = 0.03），亚洲人则显着高于白种人（8.0 vs 4.6，p = 0.02）。与白种人相比，西班牙裔人的平均 SCCAI 有较高的趋势（6.9 vs 4.6，p = 0.07）。梅奥在演示中的得分也表现出类似的趋势。开 多变量 Logistic 回归显示，根据 SCCAI，亚洲人（OR 5.26，95% CI 1.24-22.42）和西班牙裔人（OR 3.74；95% CI 1.02-13.66）就诊时的病情比白种人更严重。 对白人来说。这些差异可能反映了及时获得专业护理和治疗方面的差异，值得更多关注和研究。
While ulcerative colitis (UC) is well studied in Caucasian populations, less data are available on UC patients of racial/ethnic minorities, including variations in disease severity at presentation.To evaluate race/ethnicity-specific disparities in UC disease presentation among an ethnically diverse underserved population.We performed a cross-sectional study of all consecutive UC adults among a large ethnically diverse safety-net hospital from July 2014 to May 2016 to compare race/ethnicity-specific disparities in severity of disease at presentation. Severity was evaluated using the clinician-based simple clinical colitis activity index (SCCAI) and the Mayo score at time of presentation. Multivariate ordered logistic regression models were used to evaluate associations with SCCAI and Mayo scores.Among 98 UC patients (56.1% male, mean age 40.1 (SD 14.2), 32.0% were African-American, 26.7% Hispanic, 16.0% Asian, and 20.0% Caucasian. Mean Mayo score was 6.6 and mean SCCAI score was 6.5. When stratified by race/ethnicity, SCCAI scores were significantly higher in non-Caucasians compared to Caucasians (7.0 vs 4.6, p = 0.03) and in Asians compared to Caucasians (8.0 vs 4.6, p = 0.02). There was a trend toward higher mean SCCAI in Hispanics compared to Caucasians (6.9 vs 4.6, p = 0.07). Mayo scores at presentation demonstrated similar trends. On multivariate logistic regression, Asians (OR 5.26, 95% CI 1.24-22.42) and Hispanics (OR 3.74; 95% CI 1.02-13.66) had more severe disease at presentation than Caucasians based on SCCAI.Among a diverse underserved cohort of UC patients, racial/ethnic minority patients with UC, specifically Asians and Hispanics, had more severe disease at presentation compared to Caucasians. The differences may reflect disparities in timely access to specialty care and treatment and deserves greater attention and research.