Unequal Burden: Racial Differences in Mortality, Complications, and Resource Utilization in Immune Thrombocytopenia Hospitalizations

不平等的负担:免疫性血小板减少症住院患者的死亡率、并发症和资源利用方面的种族差异

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Abstract

Introduction Immune thrombocytopenia (ITP) is characterized by the autoimmune destruction of platelets and is a diagnosis of exclusion. It can range from asymptomatic to spontaneous bleeding. Race significantly affects healthcare utilization and clinical outcomes of ITP hospitalizations. We aimed to determine the number of ITP hospitalizations in 2022 and investigate how race influences admission, clinical outcomes, and healthcare utilization. Methods We retrospectively analyzed ITP-related hospitalizations using the 2022 National Inpatient Sample (NIS). Patients were categorized by race into six groups: White, African American, Hispanic, Asian or Pacific Islander, Native American, and Other. Data analysis was conducted using STATA/BE version 18.5. Univariate and multivariable logistic regression models were used to assess the associations between race, clinical outcomes, and healthcare utilization metrics. Results In 2022, 315,277 hospitalizations were recorded for ITP. Of these, 56.35% were male and 43.65% were female. 64.5% of patients identified themselves as White, 12.5% as Hispanic, 13.3% as African-American, 3.5% as Asian or Pacific Islander, 0.9% as Native American, and 2.9% as other minority groups. The highest in-hospital mortality among ITP patients was observed in Asian or Pacific Islander individuals (8.83%), followed by African American (8.32%) and those categorized as Other (8.25%). Mortality rates were slightly lower in Native American (7.54%) and White (7.22%) patients, while Hispanic patients had the lowest rate (6.80%), with a p-value <0.001. Conclusion This study reveals significant racial and socio-economic disparities in hospitalization outcomes among patients with ITP. Minority populations, particularly Asian or Pacific Islander, African American, and Native American patients, experienced higher mortality rates. These findings highlight the urgent need for targeted interventions, inclusive clinical research, and policy reforms to address social determinants of health and ensure equitable care and outcomes for all individuals affected by ITP.

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