Health disparities in infants with hypertrophic pyloric stenosis

- Health disparities in infants exist, particularly for African-American and poor infants.
- There is a paucity of work examining whether socioeconomic factors affect care in infants with pyloromyotomy.
- This is the first study to show that health disparities exist in illness severity in infants with pyloric stenosis.
- African-American and underinsured infants are at more risk of presenting with metabolic derangements.

BackgroundThis study investigates whether health disparities exist in infants with hypertrophic pyloric stenosis (HPS), to identify factors affecting definitive treatment, and if more morbidity occurs.MethodsA 6-year retrospective analysis was performed on infants with HPS. Analysis of variance was used to evaluate the impact of socioeconomic factors on disease severity and hospitalization. General linear models were used to assess the impact of risk factors on the outcomes.ResultsThere were a total of 584 infants. African-American's had lower serum chloride (P < .001), higher bicarbonate (P = .001), and sodium levels (P = .006), adding to longer hospitalization than whites (P = .03). Uninsured infants had lower sodium and chloride (P < .001) and higher bicarbonate (P < .001), resulting in a longer time to operation (P = .05) than privately insured infants. In multivariable analyses, African-American's were associated with chloride (P = .002) and higher bicarbonate (P = .009), and uninsured status remained significantly associated with all electrolyte abnormalities.ConclusionsAfrican-American and poorly insured infants with HPS had greater risk of metabolic derangements. This required more time to correct dehydration and electrolytes, adding to longer hospitalizations.