title: Rates of hospitalization among African American and Caucasian American patients with Crohn's disease seen at a tertiary care center.
abstract: There is equivocal evidence regarding differences in the clinical course and outcomes of Crohn's disease (CD) among African Americans compared with Caucasian Americans. We sought to analyze whether African Americans with CD are more likely to be hospitalized for CD-related complications when compared with Caucasian Americans with CD.
  
  
  
  We conducted a retrospective cohort study including 909 African Americans and Caucasian Americans with CD who were seen at our tertiary care Inflammatory Bowel Disease (IBD) referral center between 2000 and 2013. We calculated the rate of hospitalization for CD-related complications among African Americans and Caucasian Americans separately. Zero-inflated Poisson regression models with robust variance estimates were used to estimate crude and multivariable adjusted rate ratios (RR) for CD-related hospitalizations. Multivariable adjusted models included adjustment for age, sex, duration of CD, smoking and CD therapy.
  
  
  
  The cumulative rate of CD-related hospital admissions was higher among African American patients compared with Caucasian American patients (395.6/1000 person-years in African Americans vs. 230.4/1000 person-years in Caucasian Americans). Unadjusted and multivariable adjusted rate ratios for CD-related hospitalization comparing African Americans and Caucasian Americans were 1.59 (95% confidence interval [95%CI]: 1.10-2.29; P=0.01) and 1.44 (95%CI: 1.02-2.03; P=0.04), respectively.
  
  
  
  African Americans with CD followed at a tertiary IBD-referral center had a higher rate for CD-related hospitalizations compared with Caucasian Americans. Future studies should examine whether socioeconomic status and biologic markers of disease status could explain the higher risk observed among African Americans.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA carolinewalker@uabmc.edu.
authors.forename: Caroline H
authors.initials: CH
authors.lastname: Walker
authors.affiliation: Department of Internal Medicine, University of Alabama at Birmingham, Montgomery, AL, USA.
authors.forename: Sumant S
authors.initials: SS
authors.lastname: Arora
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Lisandro D
authors.initials: LD
authors.lastname: Colantonio
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Donny D
authors.initials: DD
authors.lastname: Kakati
authors.affiliation: Department of Medicine-Gastroenterology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Fitzmorris
authors.affiliation: Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Chu
authors.affiliation: Department of Medicine-Gastroenterology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Talha A
authors.initials: TA
authors.lastname: Malik
keywords: African American; Caucasian American; Crohn’s disease; racial disparity