Jessica Papillon-Smith1, Basel Imam2, Valerie Patenaude3, Haim Arie Abenhaim4. 1. Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 2. University of Arizona College of Medicine, Phoenix, Arizona. 3. Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada. 4. Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada. Electronic address: haim.abenhaim@gmail.com.
Abstract
STUDY OBJECTIVE: To evaluate whether socioeconomic variables influence the management and outcomes of ectopic pregnancies. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Hospitals in the United States participating in the Health Care Cost and Utilization Project. PATIENTS: Women (n = 35 535) with a primary discharge diagnosis of ectopic pregnancy. INTERVENTIONS: Effect of socioeconomic factors and race/ethnicity on management and adverse outcomes of ectopic pregnancy. MEASUREMENTS AND MAIN RESULTS: During the 9-year study, 35 535 ectopic pregnancies were identified. The development of hemoperitoneum in 8706 patients (24.50%) was the most common complication. Asian race was the sociodemographic variable most predictive of hemoperitoneum (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.24-1.61; p < .01) and transfusion (OR, 1.62; 95% CI, 1.39-1.89; p < .01), and Medicare status was most influential on prolonged hospitalization (OR, 1.83; 95% CI, 1.36-2.47; p < .01). Major complications were not affected by socioeconomic factors. Laparotomy in 25 075 patients (70.6%) was the most common treatment option. Patients of Asian or Pacific Islander descent were least likely to be treated non-surgically (OR, 0.62; 95% CI, 0.51-0.76; p < .01), whereas Medicare recipients were most likely to be treated non-surgically (OR, 1.70; 95% CI, 1.32-2.18; p < .01). All non-white groups were less likely to undergo a laparoscopic approach. CONCLUSION: Major complications from ectopic pregnancy are not influenced by socioeconomic variables; however, less serious complications and management approaches are persistently affected.
STUDY OBJECTIVE: To evaluate whether socioeconomic variables influence the management and outcomes of ectopic pregnancies. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Hospitals in the United States participating in the Health Care Cost and Utilization Project. PATIENTS: Women (n = 35 535) with a primary discharge diagnosis of ectopic pregnancy. INTERVENTIONS: Effect of socioeconomic factors and race/ethnicity on management and adverse outcomes of ectopic pregnancy. MEASUREMENTS AND MAIN RESULTS: During the 9-year study, 35 535 ectopic pregnancies were identified. The development of hemoperitoneum in 8706 patients (24.50%) was the most common complication. Asian race was the sociodemographic variable most predictive of hemoperitoneum (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.24-1.61; p < .01) and transfusion (OR, 1.62; 95% CI, 1.39-1.89; p < .01), and Medicare status was most influential on prolonged hospitalization (OR, 1.83; 95% CI, 1.36-2.47; p < .01). Major complications were not affected by socioeconomic factors. Laparotomy in 25 075 patients (70.6%) was the most common treatment option. Patients of Asian or Pacific Islander descent were least likely to be treated non-surgically (OR, 0.62; 95% CI, 0.51-0.76; p < .01), whereas Medicare recipients were most likely to be treated non-surgically (OR, 1.70; 95% CI, 1.32-2.18; p < .01). All non-white groups were less likely to undergo a laparoscopic approach. CONCLUSION: Major complications from ectopic pregnancy are not influenced by socioeconomic variables; however, less serious complications and management approaches are persistently affected.
Authors: Jennifer Y Hsu; Ling Chen; Arielle R Gumer; Ana I Tergas; June Y Hou; William M Burke; Cande V Ananth; Dawn L Hershman; Jason D Wright Journal: Am J Obstet Gynecol Date: 2017-03-10 Impact factor: 8.661
Authors: V Blagoeva Atanasova; J Arevalo-Serrano; E Antolin Alvarado; Santiago García-Tizón Larroca Journal: BMC Public Health Date: 2018-10-11 Impact factor: 3.295