S399 The Effect of Race and Ethnicity on Colon Ischemia Outcomes

Introduction: Colon ischemia (CI) is the most common cause of intestinal ischemic injury and a frequent cause of lower gastrointestinal bleeding. We conducted a multicenter study to determine the effect of race and ethnicity on the outcomes of CI. Methods: We reviewed the charts of all patients who underwent colonoscopy at Montefiore Medical Center and Yale New Haven Medical Center from January 1, 2008 to December 31, 2023. Inclusion determinants were (1) clinical presentation consistent with CI; (2) colonoscopic findings consistent with CI; and (3) colonic pathology consistent with CI. Patients with CI were followed from their diagnosis for 90 days to determine outcomes including mortality and colectomy. Cox proportional hazard regression was used to determine the relationship of race, and ethnicity with outcomes. Results: A total of 921 patients with CI were identified, 151 were Hispanic (Black and White), 147 were non-Hispanic Black, 565 were non-Hispanic White, and 58 refused to identify race or ethnicity. 30-day mortality was similar between non-Hispanic Black and non-Hispanic White patients (hazard ration [HR] = 0.61, 95%: 0.22—1.72, P=0.35), Hispanic and non-Hispanic White patients (HR = 0.41, 95%: 0.11—1.57, P= 0.19), and Hispanic and non-Hispanic Black patients (HR = 0.67, 95%: 0.14–3.12, P= 0.61). Thirty-day colectomy rates were lower for non-Hispanic Black patients than non-Hispanic White patients (HR = 0.23, 95% 0.08—0.67, P= 0.01), and were similar for Hispanic and non-Hispanic White patients (HR = 0.64, 95%: 0.27—1.50, P= 0.30) and for Hispanic and non-Hispanic Black patients (HR = 2.82, 95%: 0.80–10.01, P= 0.11). 30-day survival was worse for male patients than female patients (HR = 3.86, 95%: 1.63—9.12, P= 0.002), and 30-day colectomy rate was higher in male patients as well (HR = 2.43, 95%: 1.31—4.51, P= 0.01). Conclusion: We found no difference in 30-day mortality between non-Hispanic Black and non-Hispanic White patients, between Hispanic and non-Hispanic White patients, or between Hispanic and non-Hispanic Black patients. We found a difference in 30-day colectomy rates for non-Hispanic Black and non-Hispanic White patients, but no difference between Hispanic and non-Hispanic White patients or between Hispanic and non-Hispanic Black patients.