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Analysis of Inpatient Endometriosis and Associated Factors from the 2016-2020 National Inpatient Sample (NIS)

Rachwal, Brenna
http://orcid.org/0009-0002-6712-3550
http://rave.ohiolink.edu/etdc/view?acc_num=ucin168477101152075

Abstract Details

2023, MPH, University of Cincinnati, Medicine: Biostatistics.
Background: Endometriosis is a chronic inflammatory disease in which endometrial-like tissue grows outside of the uterus, causing pain, infertility, and other symptoms that lead to a significant reduction in quality of life. This condition is only diagnosable via laparoscopic surgery. This high barrier to diagnosis, as well as societal normalization of symptoms, lead to an estimated 4-to-11-year period between symptom onset and diagnosis. A strong need exists for a set of non-invasive diagnostic guidelines to reduce the symptom-to-diagnosis period and to detect undiagnosed individuals. This study seeks to describe the inpatient population of endometriosis, identify and assess factors associated with endometriosis presence, and proposes potential predictors that may be utilized in such a set of non-invasive diagnostic guidelines. Methods: Using data from the 2016-2020 National Inpatient Sample, we investigated demographic and comorbidity factors that were associated with endometriosis. The distribution of each variable in endometriosis-present and non-endometriosis-present hospitalizations were compared. These factors were then utilized in a logistic regression model and adjusted odds ratios were obtained. To investigate potential treatment disparities, healthcare utilization (length of stay and total charges) for each type of expected payer were calculated. Results: Overall, endometriosis was present in 0.3% of inpatient hospitalizations for women aged 12 and over. Among clinical comorbidities, uterine fibroids, anxiety, gastro-esophageal reflux disease, excessive and irregular menstruation, abnormal uterine and vaginal bleeding, excessive menstrual pain, migraines, and autoimmune disorders had a significantly higher risk of endometriosis than those who did not have the condition. Hypertension had a lower risk for endometriosis compared to those who did not have the condition, and obesity did not have a significant effect. For demographics, Asian race had the highest risk, as did private insurance, Northeast location, rural locality, and high-income ZIP codes. This logistic regression model produced an area under the curve of 0.873. Conclusions: The logistic regression model suggests a demographic profile of the highest risk patients - most notably Asian and White women with private insurance from high-income ZIP codes. This may represent the population who can afford what is often a long and expensive string of hospital visits to get a definitive diagnosis, rather than the distribution of the disease. Further investigation is needed to determine the extent that this bias affects the perceived distribution of the disease. Many clinical comorbidities show a strong association with heighted risk of endometriosis, presenting a strong argument for their presence in non-invasive diagnostic guidelines.
Katherine Burns, Ph.D. (Committee Member)
Marepalli Rao, Ph.D. (Committee Chair)
20 p.
Biostatistics
National Inpatient Sample; Endometriosis; Inpatient

Recommended Citations

Citations

  • Rachwal, B. (2023). Analysis of Inpatient Endometriosis and Associated Factors from the 2016-2020 National Inpatient Sample (NIS) [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin168477101152075

    APA Style (7th edition)

  • Rachwal, Brenna. Analysis of Inpatient Endometriosis and Associated Factors from the 2016-2020 National Inpatient Sample (NIS). 2023. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin168477101152075.

    MLA Style (8th edition)

  • Rachwal, Brenna. "Analysis of Inpatient Endometriosis and Associated Factors from the 2016-2020 National Inpatient Sample (NIS)." Master's thesis, University of Cincinnati, 2023. http://rave.ohiolink.edu/etdc/view?acc_num=ucin168477101152075

    Chicago Manual of Style (17th edition)

ucin168477101152075
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© 2023, some rights reserved.Creative Commons License Analysis of Inpatient Endometriosis and Associated Factors from the 2016-2020 National Inpatient Sample (NIS) by Brenna Rachwal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by University of Cincinnati and OhioLINK.