Ali, Rowanne

Desai, Amar

Freeman, Esther

Prasad, Sonya

George Washington University: Health Sciences Research Commons (HSRC)

Analyzing racial disparities among inpatient admissions for Kaposi’s sarcoma of the skin in the United States Transmissions 0.04x base case• In the last decade, the global incidence of Kaposi’s sarcoma (KS) has dramatically decreased with the widespread availability and scale-up of antiretroviral therapy (ART). Yet, cases of KS are still seen in the United States (US), with higher incidence rates in the US documented among young Black men compared to their non-Hispanic white counterparts.1• While higher incidence rates may be linked to late-stage HIV diagnoses and delayed treatment, the severity of KS in this population has not yet been reported nationally. • Here we aimed to characterize inpatient admissions among patients with a diagnosis of KS of the skin using the 2017 Nationwide Inpatient Sample (NIS), a representative sample of inpatient admissions in the US. Rowanne Ali BS1,2, Sonya Prasad MSc1,3, Amar Desai MPH4, Esther Freeman MD PhD1,5Distribution of Inpatient Admissions of Patients Diagnosed with Kaposi’s sarcoma (KS) of the Skin in the U.S. in 2017CONCLUSION1 - Massachusetts General Hospital, Harvard Medical School, Boston, MA; 2 - The George Washington University School of Medicine, Washington D.C.; 3 - Icahn School of Medicine, The Mount Sinai Hospital, New York, NY; 4 - Rutgers New Jersey Medical School, Newark, NJ; 5 - Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA. METHODSINTRODUCTION• We searched the 2017 NIS, a stratified representative sample of all hospital admissions in the US, for all hospital admissions of adult patients with a primary or secondary discharge diagnosis of KS of the skin or subcutaneous type (ICD-10 C46.0-C46.1). • Cross sectional analysis was performed to report demographics of admitted patients, discharge diagnoses, and characteristics of hospital stay. Chi square and one-way ANOVA analyses were performed in SPSS ® (version 28.0.1). • Frequencies are reported with NIS weighting, to more accurately represent the full spectrum of hospitalizations in the US.RESULTS• We extracted data for 890 weighted inpatient cases of KS. The median age was 46 years (46 years (IQR 34, 56)), most patients were male (89%) and either listed as White (34%) or Black (41%). Of 890 discharges, 84% were admitted with a primary or secondary diagnosis of HIV. • The largest proportion of patients were in the bottom quartile for median household income by zip code (39.3%), with the highest disparity among Black patients compared with White patients - 50.7% vs. 28.8% in the bottom quartile, respectively (p <.001). • The largest proportion of cases were seen in the US South (42%), where most Black patients were admitted (54%). • Black patients had the longest mean length of stay of 9.2 days, compared with all other races (p<.001). Among the total cohort, 7.3% of all admissions died.• The distribution of inpatient admissions of patients diagnosed with KS of the skin in the US is largely skewed towards Black males in the lowest income bracket of the US, especially in the US South.   • Stark disparities seen in this population raise important questions about structural racism and upstream causes of HIV-related admissions in the US healthcare system.• Prospective studies are needed to better characterize racial disparities among patients suffering from all types of severe KS as well as the root cause of such outcomes, especially as preventive measures for severe infection are widely available. 1. Kumar, V., Soni, P., Garg, M., Hashmi, A. T., & Chandra, A. B. (2019). Racial disparities in incidence & survival of Kaposi's sarcoma in the United States. The Indian journal of medical research, 149(3), 354–363. https://doi.org/10.4103/ijmr.IJMR_1436_172. White, Donna L. PhDa,b,c,d,e; Oluyomi, Abiodun PhD, MSd; Royse, Kathryn PhDb; Dong, Yongquan MSb; Nguyen, Harrison MDb; Chang, Elaine MDb,f; Richardson, Peter PhDb; Jiao, Li PhDa,b,c,d,e; Garcia, Jose M. MDg,h; Kramer, Jennifer R. PhDb,c,d; Thrift, Aaron P. PhDd,i; Chiao, Elizabeth MD, MPHb,c,d,j Incidence of AIDS-Related Kaposi Sarcoma in All 50 United States From 2000 to 2014, JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1, 2019 - Volume 81 - Issue 4 - p 387-394 doi: 10.1097/QAI.0000000000002050 3. Social determinants of late stage HIV ... - UNLV libraries. (n.d.). Retrieved January 15, 2022, from https://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=1222&context=jhdrpReferences:White Black Othern = 300 n = 360 n = 215Frequency (n) % Frequency (n) % Frequency (n) %Age (categorical) (years)18-39 90 30.0 165 45.8 55 25.640-49 70 23.3 70 19.4 75 34.950-59 60 20.0 65 18.1 40 18.6>60 80 26.7 60 16.7 45 20.9SexMale 280 93.3 320 88.9 185 86.0Female 20 6.7 40 11.1 215 100.0Median Household Income - Quartile0 – 25% 85 28.3 180 50.0 80 37.226 – 50% 55 18.3 90 25.0 45 20.951 – 75% 75 25.0 55 15.3 35 16.376 – 100% 80 26.7 30 8.3 45 20.9Bedsize of HospitalSmall 75 25.0 60 16.7 25 11.6Medium 70 23.3 70 19.4 30 14.0Large 155 51.7 230 63.9 160 74.4Teaching StatusRural 10 3.3 5 1.4 5 2.3Urban/ Non-Teaching 25 8.3 55 15.3 40 18.6Urban/ Teaching 265 88.3 300 83.3 170 79.1Region of HospitalNortheast 40 13.3 85 23.6 45 20.9Midwest 45 15.0 55 15.3 10 4.7South 110 36.7 195 54.2 70 32.6West 105 35.0 25 6.9 90 41.9DispositionAdmitted and Treated 150 50.0 245 68.1 135 62.8Short-term hospital 20 6.7 20 5.6 15 7.0Another type of facility 60 20.0 30 8.3 20 9.3Home health care (HHC) 40 13.3 45 12.5 20 9.3Died 25 8.3 15 4.2 25 11.6Primary PayerMedicare 105 35.0 125 34.7 65 30.2Medicaid 75 25.0 140 38.9 100 46.5Private Insurance 80 26.7 65 18.1 40 18.6Self-Pay 25 8.3 20 5.6 10 4.7No Charge 0 0.0 5 1.4 0 0.0Other 15 5.0 5 1.4 0 0.0

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Analyzing racial disparities among inpatient admissions for Kaposi’s sarcoma of the skin in the United States

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Analyzing racial disparities among inpatient admissions for Kaposi’s sarcoma of the skin in the United States

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