Population-based study on the effect of socioeconomic factors and race on management and outcomes of 35,535 inpatient ectopic pregnancies.
OBJECTIVE
To evaluate whether socioeconomic variables influence the management and outcomes of ectopic pregnancies.


METHODS
Retrospective cohort study (Canadian Task Force classification II-2).


METHODS
Hospitals in the United States participating in the Health Care Cost and Utilization Project.


METHODS
Women (n = 35 535) with a primary discharge diagnosis of ectopic pregnancy.


METHODS
Effect of socioeconomic factors and race/ethnicity on management and adverse outcomes of ectopic pregnancy.


RESULTS
During the 9-year study, 35 535 ectopic pregnancies were identified. The development of hemoperitoneum in 8706 patients (24.50%) was the most common complication. Asian race was the sociodemographic variable most predictive of hemoperitoneum (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.24-1.61; p < .01) and transfusion (OR, 1.62; 95% CI, 1.39-1.89; p < .01), and Medicare status was most influential on prolonged hospitalization (OR, 1.83; 95% CI, 1.36-2.47; p < .01). Major complications were not affected by socioeconomic factors. Laparotomy in 25 075 patients (70.6%) was the most common treatment option. Patients of Asian or Pacific Islander descent were least likely to be treated non-surgically (OR, 0.62; 95% CI, 0.51-0.76; p < .01), whereas Medicare recipients were most likely to be treated non-surgically (OR, 1.70; 95% CI, 1.32-2.18; p < .01). All non-white groups were less likely to undergo a laparoscopic approach.


CONCLUSIONS
Major complications from ectopic pregnancy are not influenced by socioeconomic variables; however, less serious complications and management approaches are persistently affected.
Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Jessica
J
Papillon-Smith
University of Arizona College of Medicine, Phoenix, Arizona.
Basel
B
Imam
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada.
Valerie
V
Patenaude
Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada. Electronic address: haim.abenhaim@gmail.com.
Haim Arie
HA
Abenhaim
D000328:Adult; D015331:Cohort Studies; D005260:Female; D054625:Healthcare Disparities; D006465:Hemoperitoneum / Q000453:epidemiology* / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D019458:Insurance Coverage; D007813:Laparotomy / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D013513:Obstetric Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D016017:Odds Ratio; D010351:Patient Discharge; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
Ectopic pregnancy; Management; Outcomes; Socioeconomic factors