BACKGROUND The impact of English proficiency on gastrointestinal bleeding (GIB) outcomes remains unclear. In this analysis, we compare inpatient GIB outcomes between patients with English as their primary language (EPL) and those with a primary language other than English (PLOE). METHODS Using the 2019 State Inpatient Databases for New Jersey, Maryland, and Michigan, we created an analysis cohort of GIB hospitalizations using International Classification of Diseases, 10th Revision codes. Patients were stratified by primary language (EPL vs PLOE) and type of bleeding (variceal upper GI bleeding [VUGIB], nonvariceal upper GI bleeding [NVUGIB], and lower GI bleeding (LGIB)]. Regression analyses were used to compare mortality, 30-day readmissions, and length of stay. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported. P < 0.05 was considered statistically significant. RESULTS In the cohort, 5.5%-10% of the patients spoke a primary language other than English. Endoscopy utilization was lower among patients with PLOE vs EPL for NVUGIB (17.2% vs 21.2%, P < 0.001) and LGIB (26.3% vs 29.2%, P = 0.027). Patients with PLOE had higher odds of dying of VUGIB (aOR 1.45, 95% CI 1.16-2.48) and LGIB (aOR 1.71, 95% CI 1.22-2.12). Patients with PLOE were also more likely to be readmitted after NVUGIB (aOR 1.75, 95% CI 1.64-1.81). However, after controlling for the percentage of patients with PLOE discharged from each hospital, the disparities in mortality and readmissions were no longer detected. DISCUSSION Disparities exist in GIB outcomes among patients with PLOE, but these gaps narrow at hospitals with higher percentages of patients with PLOE. Cultural and linguistic competence may improve outcomes in this vulnerable group.

中文翻译：

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患者的主要语言对住院胃肠道出血结果的影响。

背景 英语水平对胃肠道出血 (GIB) 结局的影响仍不清楚。在本分析中，我们比较了以英语为主要语言 (EPL) 的患者和以英语以外的主要语言 (PLOE) 为主要语言的患者的住院 GIB 结局。方法 使用新泽西州、马里兰州和密歇根州 2019 年州住院患者数据库，我们使用国际疾病分类第 10 版修订代码创建了一个 GIB 住院分析队列。按主要语言（EPL 与 PLOE）和出血类型（静脉曲张性上消化道出血 [VUGIB]、非静脉曲张上消化道出血 [NVUGIB] 和下消化道出血 (LGIB)] 对患者进行分层。使用回归分析来比较死亡率，30天再入院率和住院时间。报告了调整后的比值比 (aOR) 和 95% 置信区间 (CI)。P < 0.05 被认为具有统计学意义。结果 在队列中，5.5%-10% 的患者说出主要信息PLOE 患者与 EPL 患者的 NVUGIB（17.2% vs 21.2%，P < 0.001）和 LGIB（26.3% vs 29.2%，P = 0.027）的内窥镜利用率较低。PLOE 患者的死亡几率更高VUGIB（aOR 1.45，95% CI 1.16-2.48）和 LGIB（aOR 1.71，95% CI 1.22-2.12）的患者。PLOE 患者在 NVUGIB 后再次入院的可能性也更大（aOR 1.75，95% CI 1.64-1.81）然而，在控制了各医院出院的 PLOE 患者比例后，不再发现死亡率和再入院率的差异。讨论 PLOE 患者的 GIB 结果存在差异，但在 PLOE 患者比例较高的医院，这些差异会缩小。文化和语言能力可能会改善这一弱势群体的结果。