Background To examine differences in comorbidities and surgical management based on socioeconomics in hospitalized children with Crohn’s disease (CD). Methods Using the Kids’ Inpatient Database for 2006–2012, we identified patients (<21 years) with a CD diagnosis. Cases were analyzed and stratified by median parental income by zip code. Multivariable logistic regression was performed. Results Of the 28,337 pediatric CD hospitalizations identified, patients were more likely male (51.1%), non-Hispanic white (71.3%), and had a mean age of 15.9 years. The proportion of minority patients increased as income quartile declined. Higher income quartile patients were more likely to be coded with anxiety and less likely with anemia. The highest income quartile was more likely to have a bowel obstruction, and peritoneal/intestinal abscess and was also 28% more likely to undergo a major surgical procedure. Conclusions Significant variability exists in the reported comorbidities and surgical interventions associated with CD by income quartile. Lower income quartile patients are more likely to be of minority ethnicity and anemic, but less likely to undergo a major surgical procedure. Further investigation is warranted to determine whether these differences represent disease variability, differences in healthcare resource allocation, or implicit bias in management. Impact There is a disparity in the care of children and young adults with Crohn’s disease based on parental income. Links between parental income and the treatment of Crohn’s disease in children and young adults has not been assessed in national datasets in the United States. Children in the highest income quartile were more likely to undergo a major surgical procedure. The variations in healthcare for hospitalized children and young adults with CD found in this study may represent variability in patient disease, implicit bias, or a disparity in healthcare delivery across the United States.

中文翻译：

---

儿科克罗恩病合并症和手术治疗的社会经济差异

背景 研究基于社会经济学的克罗恩病 (CD) 住院儿童合并症和手术治疗的差异。方法 使用 2006-2012 年儿童住院患者数据库，我们确定了诊断为 CD 的患者（<21 岁）。根据邮政编码的父母收入中位数对病例进行分析和分层。进行了多变量逻辑回归。结果 在确定的 28,337 名儿科 CD 住院患者中，患者更可能是男性 (51.1%)、非西班牙裔白人 (71.3%)，平均年龄为 15.9 岁。随着收入四分位数的下降，少数民族患者的比例增加。收入较高的四分位数患者更有可能被编码为焦虑症，而不太可能患有贫血症。收入最高的四分位数更有可能患有肠梗阻，和腹膜/肠脓肿，接受大手术的可能性也高 28%。结论 按收入四分位数报告的与 CD 相关的合并症和手术干预存在显着差异。收入较低的四分位数患者更有可能是少数族裔和贫血，但不太可能接受大手术。需要进一步调查以确定这些差异是否代表疾病变异性、医疗资源分配的差异或管理中的隐性偏见。影响 根据父母的收入，对患有克罗恩病的儿童和年轻人的护理存在差异。美国的国家数据集中尚未评估父母收入与儿童和年轻人克罗恩病治疗之间的联系。收入最高的四分位数儿童更有可能接受大手术。本研究中发现的住院儿童和患有 CD 的年轻人的医疗保健变化可能代表了美国各地患者疾病、隐性偏见或医疗保健服务的差异。