LACK OF GENDER AND RACIAL-DIFFERENCES IN SURGERY AND MORTALITY IN HOSPITALIZED MEDICARE BENEFICIARIES WITH BLEEDING PEPTIC-ULCER

OBJECTIVE: Determine the relation of race and gender to outcome from b leeding peptic ulcer. DESIGN: Retrospective cohort study. SETTING: All acute care hospitals in the United States. PATIENTS: A 100% sample of hospitalized Medicare beneficiaries older than 64 years (n = 82,868) with a primary discharge diagnosis of peptic ulcer with hemorrhage. ME ASUREMENTS AND MAIN RESULTS: Surgical treatment was performed in 6.9% of patients, 30-day mortality was 8.5%, and average length of stay was 9.4 days. Surgery was somewhat more common in men than women (7.3% vs 6.5%, p < .001), and in whites than African Americans (6.9% vs 6.3%, p < .001), but neither race nor gender was associated with surgery in multivariable analysis adjusting for potentially confounding factors. Mortality rates were similar in African Americans and whites (8.5%), a nd somewhat higher in men than women (10.7% vs 9.3%, p < .001). In mul tivariable analysis, there was no difference in mortality across gende r and racial groups. Although unadjusted and adjusted lengths of stay were longer for African Americans and shorter for men, the differences were modest (i.e., 16% increase and 6% decrease in multivariable anal ysis, respectively, p < .0001). CONCLUSIONS: In this national sample, there is no significant gender or racial difference in therapy and out come for patients with hemorrhagic peptic ulcer. The findings raise th e possibility that studies that have shown race and gender differences in management of coronary artery disease and cancer may not be genera lizable to other common diagnoses.