Different clinical characteristics in Hispanic and non-Hispanic whites with ileal pouch-anal anastomosis: a case-control study.
BACKGROUND
Inflammatory bowel disease (IBD) is increasingly diagnosed in ethnic and racial minorities. Ileal pouch-anal anastomosis (IPAA) has become the treatment of choice for ulcerative colitis (UC) patients requiring surgery. Few studies have characterized the natural history of IPAA and the pouch outcomes in the Hispanic American population.


METHODS
Ethnicity was designated by self-report and the Hispanics who had IPAA for UC were identified from a prospectively maintained database. Demographics, clinical characteristics, and pouch outcomes were compared between Hispanic and a sample of Non-Hispanic whites (1:4 ratio) randomly selected from the same database. Exclusion criteria were patients with a preoperative diagnosis of Crohn's disease or familial adenomatous polyposis, and patients of other ethnic groups.


RESULTS
Thirty-six Hispanics with IPAA were identified. Hispanic patients were younger at UC diagnosis 23.1 ± 13.1 vs. 30.4 ± 12.6 yrs and at colectomy 31.9 ± 13.9 vs. 38.8 ± 13.8 yrs than controls. The interval between diagnosis and colectomy was comparable between the two groups. There were more uninsured in the Hispanic group than controls (13.9% vs. 2.8%). There were no significant differences in gender distribution, family history of IBD, smoking history, extent of UC, fulminant colitis, pouch configuration, stage of pouch, presence of extraintestinal manifestations, or concurrent autoimmune disorders. Pouch-related disorders and pouch failure were also similar.


CONCLUSIONS
There appeared to be some difference in the preoperative characteristics of patients who underwent colectomy for UC between Hispanics and non-Hispanic whites, but outcomes after the restorative proctocolectomy with IPAA were comparable. Further studies are needed to characterize the natural history of UC and IPAA in the Hispanic population and the associated biosocioeconomic factors.
Lian
Lei
L
Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Moore
Lauren
L
Wu
Xiao-Jian
XJ
He
Xiao-Sheng
XS
Lan
Ping
P
Shen
Bo
B
D000328:Adult; D001003:Anal Canal / Q000473:pathology* / Q000601:surgery; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000208:ethnology* / Q000473:pathology / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000209:etiology; D016737:Proctocolectomy, Restorative; D011379:Prognosis; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult