P1177 - Racial Disparities in Mortality Among Hospitalized Patients With Inflammatory Bowel Disease: A Meta-Analysis

Youssef Hafez, MBChB¹, Ahmed H. Elmasry, ², Hamdy M. Elsaid, ³, Abdulrahman Saad El-Rayik, ⁴, Mohamed Shaban. Ibrahim, ⁵, Mahmoud N. Abdelwahab, MD⁶, Clive J. Miranda, DO, MSc⁷
1Alexandria University, Alexandria, Al Iskandariyah, Egypt; 2CUNY Hunter College, Brooklyn, NY; 3CUNY Medgar Evers College, New York, USA, Brooklyn, NY; 4Delta University for Science and technology, Al-Mansoura, Ad Daqahliyah, Egypt; 5Delta University for Science and Technology, Kafr ash Shaykh, Kafr ash Shaykh, Egypt; 6Capital Health Regional Medical Center, Flemington, NJ; 7CHI Health Creighton University Medical Center, Omaha, NE

Introduction: Racial disparities in inflammatory bowel disease (IBD) outcomes have been increasingly reported, especially among hospitalized patients. However, the extent to which these disparities affect in-hospital mortality remains unclear due to conflicting findings across studies.

Methods: This meta-analysis followed PRISMA guidelines to evaluate racial disparities in in-hospital mortality among IBD patients. A systematic search of PubMed, Scopus, and Google Scholar (2020–2025) identified 1,155 records. After removing duplicates, titles, abstracts, and full texts were screened independently by blinded reviewers using Rayyan. Discrepancies were resolved through discussion or adjudication by a third reviewer. Six studies (n = 712,033) met inclusion criteria. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random- or fixed-effects models were applied. Publication bias was assessed using funnel plots and Egger’s test. Analyses were conducted in RevMan 5.4.1.

Results: Pooled analysis showed no significant difference in in-hospital mortality between Black and White patients (OR 1.14, 95% CI [0.87–1.56], p = 0.35,) with substantial heterogeneity (I² = 98%, Chi-square p = 161.21). Subgroup analysis showed higher mortality in Black patients with UC (OR 1.40, 95% CI [1.25–1.56], p < 0.00001). Sensitivity analysis excluding Galoosian 2020 reduced heterogeneity (I² = 47%, Chi-square p = 5.71) and revealed higher mortality among Black patients (OR 1.29, 95% CI [1.16–1.43], p < 0.00001) in IBD (UC or CD) subgroup. No significant mortality difference was found between Hispanic and non-Hispanic White patients overall (OR 1.01, 95% CI [0.84–1.21], p = 0.96), though excluding Zhornitskiy 2025 showed modest increased mortality among Hispanic patients (OR 1.06, 95% CI [1.01–1.12], p = 0.03; I² = 0%, Chi-square p=0.61). Asian patients showed no significant difference in mortality (OR 0.96, 95% CI [0.79–1.16], p = 0.65) (I² = 14%, Chi-square p = 0.28).

Discussion: While overall racial disparities in IBD-related in-hospital mortality appear limited, subgroup and sensitivity analyses suggest significant disparities among Black patients with UC and modest disparities among Hispanic patients. These differences may be masked in pooled estimates. Future studies should use prospective designs and examine social determinants of health to address inequities in IBD care.


Figure: Figure A: Pooled Odds Ratios for In-Hospital Mortality in Black vs. White Patients with IBD - Before Sensitivity Analysis.
Figure B: Pooled Odds Ratios for In-Hospital Mortality in Black vs. White Patients with IBD - After Sensitivity Analysis (Excluding Galoosian 2020).



Figure: Figure C: In-Hospital Mortality in Hispanic vs. White Patients with IBD - Before Sensitivity Analysis.
Figure D: In-Hospital Mortality in Hispanic vs. White Patients with IBD - After Sensitivity Analysis (Excluding Zhornitskiy 2025).
Figure E: In-Hospital Mortality in Asian vs. White Patients with IBD.

Disclosures:
Youssef Hafez indicated no relevant financial relationships.
Ahmed H. Elmasry indicated no relevant financial relationships.
Hamdy M. Elsaid indicated no relevant financial relationships.
Abdulrahman Saad El-Rayik indicated no relevant financial relationships.
Mohamed Ibrahim indicated no relevant financial relationships.
Mahmoud N. Abdelwahab indicated no relevant financial relationships.
Clive Miranda indicated no relevant financial relationships.

Youssef Hafez, MBChB¹, Ahmed H. Elmasry, ², Hamdy M. Elsaid, ³, Abdulrahman Saad El-Rayik, ⁴, Mohamed Shaban. Ibrahim, ⁵, Mahmoud N. Abdelwahab, MD⁶, Clive J. Miranda, DO, MSc⁷. P1177 - Racial Disparities in Mortality Among Hospitalized Patients With Inflammatory Bowel Disease: A Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.