Race affects outcome among infants with intestinal failure

Robert H. Squires*, Jane Balint, Simon Horslen, Paul W. Wales, Jason Soden, Christopher Duggan, Ruosha Li, Steven H. Belle, Cartland Burns, George Mazariegos, Anita Nucci, Jane Anne Yaworski, Danielle Sebbens, Rhonda Cunningham, Daniel Kamin, Tom Jaksic, Hueng Bae Kim, Sharon Collier, Melanie Connolly, Daniel H. TeitelbaumPamela Brown, Michele Johnson, Robert Drongowski, Christina Valentine, Steven Teich, Beth Skaggs, Robert Venick, Martin G. Martin, Patty Beckwith, James Dunn, Douglas G. Farmer, Laurie Reyen, Susan Rhee, Diana Farmer, Sang Mo Kang, Lane Bower, Debra Sudan, David Mercer, Dean L. Antonson, Steve C. Raynor, Brandy Sunderman, Kris Seipel, J. Andres Martinez, Brent Polk, Martha Ballew, Beth A. Carter, Mary Brandt, Saul Karpen, Sara Philips, Kristin Brown

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objective: Intestinal failure (IF) is a rare, devastating condition associated with significant morbidity and mortality. We sought to determine whether ethnic and racial differences were associated with patient survival and likelihood of receiving an intestinal transplant in a contemporary cohort of children with IF.

Methods: This was an analysis of a multicenter cohort study with data collected from chart review conducted by the Pediatric Intestinal Failure Consortium. Entry criteria included infants≤ 12 months receiving parenteral nutrition (PN) for ≥ 60 continuous days and studied for at least 2 years. Outcomes included death and intestinal transplantation (ITx). Race and ethnicity were recorded as they were in the medical record. For purposes of statistical comparisons and regression modeling, categories of race were consolidated into ''white'' and ''nonwhite'' children.

Results: Of 272 subjects enrolled, 204 white and 46 nonwhite children were available for analysis. The 48-month cumulative incidence probability of death without ITx was 0.40 for nonwhite and 0.16 for white children (P< 0.001); the cumulative incidence probability of ITx was 0.07 for nonwhite versus 0.31 for white children (P=0.003). The associations between race and outcomes remained after accounting for low birth weight, diagnosis, and being seen at a transplant center.

Conclusions: Race is associated with death and receiving an ITx in a large cohort of children with IF. This study highlights the need to investigate reasons for this apparent racial disparity in outcome among children with IF. Key Words: intestinal failure, intestinal transplant, outcome, race.

Original languageEnglish (US)
Pages (from-to)537-543
Number of pages7
JournalJournal of pediatric gastroenterology and nutrition
Volume59
Issue number4
DOIs
StatePublished - Oct 8 2014

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Keywords

  • Intestinal failure
  • Intestinal transplant
  • Outcome
  • Race

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

Squires, R. H., Balint, J., Horslen, S., Wales, P. W., Soden, J., Duggan, C., Li, R., Belle, S. H., Burns, C., Mazariegos, G., Nucci, A., Yaworski, J. A., Sebbens, D., Cunningham, R., Kamin, D., Jaksic, T., Kim, H. B., Collier, S., Connolly, M., ... Brown, K. (2014). Race affects outcome among infants with intestinal failure. Journal of pediatric gastroenterology and nutrition, 59(4), 537-543. https://doi.org/10.1097/MPG.0000000000000456