S1762 Ethnic Differences in Disease Severity and Surgical Outcomes Among Hispanic Patients With Inflammatory Bowel Disease at a Safety Net Academic Medical Center

Introduction: Racial and ethnic disparities in the presentation and management of inflammatory bowel disease (IBD) are increasingly recognized. Hispanic patients—one of the largest minority groups in the United States—remain underrepresented in IBD cohort studies, and differences in disease severity and access to surgical intervention are not well understood. Notably, patients with ulcerative colitis (UC) pancolitis experience significantly higher relapse and hospitalization rates compared to those with more limited disease. This study aims to compare clinical characteristics and surgical outcomes between Hispanic and non-Hispanic patients with IBD at a safety-net hospital serving a predominantly Hispanic population. Methods: We conducted a retrospective cross-sectional study of adult patients (≥18 years) with inflammatory bowel disease (IBD) who received care at a safety-net hospital in Riverside, California, between December 2017 and December 2022. Patients were identified using International Classification of Diseases-10 codes for Crohn’s disease and UC. Patients aged <18 years of age, pregnant individuals, incarcerated persons, patients with an unclear diagnosis of IBD, and those who did not follow-up at the clinic were excluded. Variables collected included age, sex, ethnicity, insurance type, disease extent and severity, history of IBD-related surgeries, steroid use, and biologic therapy. Comparative analyses were performed using chi-square tests for categorical variables and t-tests for continuous variables. Results: A total of 128 patients were included, with 68 (53.1%) identifying as Hispanic and 60 (46.9%) as non-Hispanic. Medicaid coverage was significantly more common among Hispanic patients (91.2% vs 78.3%, P = 0.041). Among those with UC, Hispanic patients had a higher prevalence of pancolitis compared to non-Hispanic patients (45.6% vs 25.0%, P = 0.015). Despite the greater disease extent, Hispanic patients were significantly less likely to undergo IBD-related surgery (17.6% vs 33.3%, P = 0.035). These findings indicate that Hispanic patients may experience more severe disease yet have reduced access to or utilization of surgical interventions. Conclusion: In this safety-net hospital cohort, Hispanic patients with UC presented with more extensive disease yet underwent fewer IBD-related surgeries compared to their non-Hispanic counterparts. These findings underscore significant disparities in disease management and outcomes.