Association of Sociodemographic Factors and the Rate of Vagotomy Performed in Patients With Gastroduodenal Ulcers.

Abstract

Operative management of gastroduodenal ulcers (GDUs) and vagotomy are increasingly rare due to success of medical therapy. Given sociodemographic factors could impact perception of medical therapy adherence and operative management, we sought to investigate the influence of sociodemographic factors on likelihood of vagotomy for patients with GDUs. The 2012-2017 Nationwide Inpatient Sample was queried for adults admitted with GDUs and gastric or duodenal operations. To assess sociodemographic associations, univariable and multivariable comparisons were made between operations with vagotomies and those without. A total of 80,980 weighted discharges and 4230 (5.2%) vagotomies were identified. In univariable comparisons, vagotomies were more likely in earlier years, among younger patients, among patients without insurance coverage, and with lower median income. In the adjusted multivariable logistic model, lower median income (OR 1.50 [1.19, 1.90] for lowest vs. highest quartile) and younger age (OR 0.69 [0.48, 0.98] for Age 80+ vs. Age 18-39) were associated with higher odds of vagotomy. Vagotomy remains a rare operative treatment for GDUs. Lower household income and Medicaid or self-pay insurance were significantly associated with performing vagotomy for GDUs. These findings suggest that socioeconomic status may play a role in operative decision-making for these conditions.