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Differences in coexisting illness do not explain racial/ethnic disparities in inpatient deaths from aspiration pneumonia

More than 20 percent of patients hospitalized for aspiration pneumonia die in the hospital. This type of pneumonia results from inflammation and infection of the lungs following inhalation of food, drink, or vomit (for example, when a person is unconscious, has had too much to drink, or has a seizure). Minority patients are more likely than white patients to die in the hospital from aspiration pneumonia, but this disparity is not because of differences in coexisting (comorbid) diseases, which can influence the risk of hospital death from some other causes, according to researchers led by George J. Stukenborg, Ph.D., of the University of Virginia.

The researchers used patient records to study 41,581 patients admitted to California hospitals for aspiration pneumonia from 1996 through 1998. They examined the independent effects of race and ethnicity on in-hospital death, while controlling for comorbid diseases.

Overall, 22 percent of the patients died during their hospitalization; half of patients in the study group were 80 years of age or older. After adjusting for baseline characteristics, including comorbid disease, blacks suffered similar in-hospital deaths as whites. Asians had a significant 17 percent lower odds of dying in the hospital than whites, and Hispanics had a significant 10 percent lower odds of dying in the hospital than non-Hispanics.

Seven of the ten most commonly occurring coexisting diseases were more prevalent among blacks and Asians than among whites, and among Hispanics compared with non-Hispanics, but these differences did not significantly affect mortality risk. Optimal adjustment for comorbid disease will better illuminate the reasons for racial and ethnic disparities in inpatient mortality, suggest the researchers. Their study was supported by the Agency for Healthcare Research and Quality (HS10134 and HS11419).

See "Comorbid disease and the effect of race and ethnicity on in-hospital mortality from aspiration pneumonia," by M. Norman Oliver, M.D., Dr. Stukenborg, Douglas P. Wagner, Ph.D., and others in the November 2004 Journal of the National Medical Association 96(11), pp. 1462-1469.

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