title: Lack of gender and racial differences in surgery and mortality in hospitalized Medicare beneficiaries with bleeding peptic ulcer.
abstract: OBJECTIVE
  Determine the relation of race and gender to outcome from bleeding peptic ulcer.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  All acute care hospitals in the United States.
  
  
  METHODS
  A 100% sample of hospitalized Medicare beneficiaries older than 64 years (n = 82,868) with a primary discharge diagnosis of peptic ulcer with hemorrhage.
  
  
  RESULTS
  Surgical treatment was performed in 6.9% of patients, 30-day mortality was 8.5%, and average length of stay was 9.4 days. Surgery was somewhat more common in men than women (7.3% vs 6.5%, p < .001), and in whites than African Americans (6.9% vs 6.3%, p < .001), but neither race nor gender was associated with surgery in multivariable analysis adjusting for potentially confounding factors. Mortality rates were similar in African Americans and whites (8.5%), and somewhat higher in men than women (10.7% vs 9.3%, p < .001). In multivariable analysis, there was no difference in mortality across gender and racial groups. Although unadjusted and adjusted lengths of stay were longer for African Americans and shorter for men, the differences were modest (i.e., 16% increase and 6% decrease in multivariable analysis, respectively, p < .0001).
  
  
  CONCLUSIONS
  In this national sample, there is no significant gender or racial difference in therapy and outcome for patients with hemorrhagic peptic ulcer. The findings raise the possibility that studies that have shown race and gender differences in management of coronary artery disease and cancer may not be generalizable to other common diagnoses.
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Cooper
authors.forename: Z
authors.initials: Z
authors.lastname: Yuan
authors.forename: G E
authors.initials: GE
authors.lastname: Rosenthal
authors.forename: A
authors.initials: A
authors.lastname: Chak
authors.forename: A A
authors.initials: AA
authors.lastname: Rimm
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D006278:Medicare; D017063:Outcome Assessment, Health Care; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality* / Q000601:surgery*; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014481:United States; D044465:White People