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Population-Based Study on the Effect of Socioeconomic Factors and Race on Management and Outcomes of 35,535 Inpatient Ectopic Pregnancies
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DOI：10.1016/j.jmig.2014.04.005.png)
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Abstract
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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. (C) 2014 AAGL. All rights reserved.
Keywords:
Ectopic pregnancy
Management
Outcomes
Socioeconomic factors
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