Disparities in hospitalization outcomes among African-American and White prostate cancer patients

- HCUP-NIS is a large database of more than 39 million all-payer inpatient care visits recorded across 1000 hospitals.
- We conducted a 3 tiered matching between African American patients and White patients who had similar demographic, clinical or treatment characteristics.
- Even after matching for above characteristics, length of stay and mortality was higher in African American patients compare to White patients.

ObjectivesThis paper aims to determine whether racial disparities exist in hospitalization outcomes among African-American and White hospitalized prostate cancer patients in the United States. We evaluated racial differences among matched groups of patients in post-operative complications, hospital length of stay and in-hospital mortality.MethodsWe identified a total of 183,856 men aged 40 years and older with a primary diagnosis of prostate cancer, of which 58,701 underwent prostatectomy, through the Nationwide Inpatient Sample, and matched all African-American patients with White patients on: 1) Demographics, 2) Demographics + Clinical presentation and 3) Demographics + Clinical presentation + Treatment. Multivariable regression analyses were conducted in SAS and estimates were reported with 95% confidence intervals.ResultsAfrican-American patients were more likely to be admitted with metastatic disease (24.8%) compared with White patients matched on demographics (17.9%), and demographics + presentation (23.6%). However, 23.9% of African-American patients received surgery compared with 38.2% and 34.2% of Whites matched on demographics and demographics + presentation, respectively. White patients had lower in-hospital mortality compared with African-American patients matched on demographics (OR: 0.72, 95% CI: 0.66-0.79), demographics + presentation (OR: 0.88, 95% CI: 0.81-0.96), but was no longer significantly lower when matched on demographics, presentation and treatment (OR: 0.92, 95% CI: 0.85-1.00).ConclusionThere were significant racial differences in outcomes among prostate cancer patients within the inpatient setting, even after accounting for demographic and presentation differences.