S1616 Racial Disparities in Mortality Among Hospitalized Patients With Inflammatory Bowel Disease: A Meta-Analysis
Bibliographic record
Abstract
Introduction: Racial disparities in inflammatory bowel disease (IBD) outcomes have been increasingly reported, especially among hospitalized patients. However, the extent to which these disparities affect in-hospital mortality remains unclear due to conflicting findings across studies. Methods: This meta-analysis followed PRISMA guidelines to evaluate racial disparities in in-hospital mortality among IBD patients. A systematic search of PubMed, Scopus, and Google Scholar (2020–2025) identified 1,155 records. After removing duplicates, titles, abstracts, and full texts were screened independently by blinded reviewers using Rayyan. Discrepancies were resolved through discussion or adjudication by a third reviewer. Six studies (n = 712,033) met inclusion criteria. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random- or fixed-effects models were applied. Publication bias was assessed using funnel plots and Egger’s test. Analyses were conducted in RevMan 5.4.1. Results: Pooled analysis showed no significant difference in in-hospital mortality between Black and White patients (OR 1.14, 95% CI [0.87–1.56], P = 0.35) with substantial heterogeneity (I² = 98%, Chi-square P = 161.21). Subgroup analysis showed higher mortality in Black patients with UC (OR 1.40, 95% CI [1.25–1.56], P < 0.00001). Sensitivity analysis excluding Galoosian 2020 reduced heterogeneity (I² = 47%, Chi-square P = 5.71) and revealed higher mortality among Black patients (OR 1.29, 95% CI [1.16–1.43], P < 0.00001) in IBD (UC or CD) subgroup. No significant mortality difference was found between Hispanic and non-Hispanic White patients overall (OR 1.01, 95% CI [0.84–1.21], P = 0.96), though excluding Zhornitskiy 2025 showed modest increased mortality among Hispanic patients (OR 1.06, 95% CI [1.01–1.12], P = 0.03; I² = 0%, Chi-square P = 0.61). Asian patients showed no significant difference in mortality (OR 0.96, 95% CI [0.79–1.16], P = 0.65) (I² = 14%, Chi-square P = 0.28). Conclusion: While overall racial disparities in IBD-related in-hospital mortality appear limited, subgroup and sensitivity analyses suggest significant disparities among Black patients with UC and modest disparities among Hispanic patients. These differences may be masked in pooled estimates. Future studies should use prospective designs and examine social determinants of health to address inequities in IBD care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.045 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.066 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".