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Crohn's disease in black children is worse in 6 ways – Dec 2015

Racial disparities in readmission, complications, and procedures in children with Crohn's disease.

Inflamm Bowel Dis. 2015 Apr;21(4):801-8. doi: 10.1097/MIB.0000000000000325.
Dotson JL1, Kappelman MD, Chisolm DJ, Crandall WV.

VitaminDWiki

Overview Dark Skin and Vitamin D contains the following summary

FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D


More to Consider in The Battle Against Crohn's Amazon $29, 2016
Book has section on Crohn's and Vitamin D


# of ways in results (below) were added by VitaminDWiki


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BACKGROUND:
Racial disparities in care and outcomes contribute to mortality and morbidity in children; however, the role in pediatric Crohn's disease is unclear. In this study, we compared cohorts of black and white children with Crohn's disease to determine the extent race is associated with differences in readmissions, complications, and procedures among hospitalizations in the United States.

METHODS:
Data were extracted from the Pediatric Health Information System (January 1, 2004-June 30, 2012) for patients with 21 years or younger hospitalized with a diagnosis of Crohn's disease. White and black cohorts were randomly selected in a 2:1 ratio by hospital. The primary outcome was time from index hospital discharge to readmission. The most frequent complications and procedures were evaluated by race.

RESULTS:
There were 4377 patients. Black children had a

  1. shorter time to first readmission and
  2. higher probability of readmission (P = 0.009) and a
  3. 16% increase in risk of readmission
    compared with white children (P = 0.01). Black children had
  4. longer length of stay and
  5. higher frequency of overall and
  6. late (30-d to 12-mo postdischarge) readmissions (P < 0.001).
  7. During index hospitalization, more black children had perianal disease and anemia (P < 0.001).
    During any hospitalization, black children had
  8. higher incidence of perianal disease,
  9. anemia, and
  10. vitamin D deficiency, [2.3% vs .9%] and
  11. greater number of perianal procedures,
  12. endoscopies, and
  13. blood product transfusion (P < 0.001).

CONCLUSIONS:
There are differences in hospital readmissions, complications, and procedures among hospitalized children related to race. It is unclear whether these differences are due to genetic differences, worse intrinsic disease, adherence, access to treatment, or treatment disparities.

Comment in
African Americans May Access the Emergency Department for Inflammatory Bowel Disease Care More Often than Whites.
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Created by admin. Last Modification: Thursday August 30, 2018 12:27:10 UTC by admin. (Version 6)

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8916 CD letter to editor.jpg admin 10 Dec, 2017 15:36 155.00 Kb 92
8915 CD index hospitalization.jpg admin 10 Dec, 2017 14:52 43.73 Kb 86
8914 Crohn's disease - black children.pdf PDF 2015 admin 10 Dec, 2017 14:51 459.29 Kb 133
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