Racial differences in hospitalizations for acute cholangitis: a nationwide time trend analysis, 2008-2018

BACKGROUND: The data on racial epidemiologic trends for acute cholangitis (AC) are scarce. Therefore, we conducted a longitudinal assessment of the racial breakdown of AC-related hospitalizations in the United States (US) over 11 years (2008-2018). METHODS: Using the National Inpatient Sample, we retrieved adult (>18 years) patients with AC. The adjusted yearly hospitalization rate per 100,000 for each race category was calculated based on the US population estimate for July 1 of the corresponding year obtained from the US Census Bureau. We followed Healthcare Cost and Utilization Project recommendations to: (1) derive a time-interrupted trend (before and after 2015), after determining that the International Classification of Diseases coding change affected AC hospitalizations because of more specific coding in the tenth revision; and (2) generate proportionate estimates using revised trend weights. RESULTS: A total of 321,849 patients with AC were included in the analysis. Before 2015, the overall hospitalizations (per 100,000 persons) increased from 16.03 in 2008 to 20.76 in 2014 (P<0.001). Following 2015, the overall hospitalizations increased from 14.34 in 2016 to 14.70 in 2018 (P=0.04). After Whites, Asians represented the ethnic group with the highest race-specific AC hospitalizations per 100,000 persons. CONCLUSIONS: This cohort study demonstrated an overall rising and disproportionate rate among different races for AC-related hospitalizations. Even though Asians constitute only 6.5% of the US population, they represent the ethnic minority with most hospitalizations for AC.