P3.152: American Indian/Alaska Native Individuals with Cystic Fibrosis at Higher Risk of Hospitalization for Pulmonary Exacerbation in Oklahoma

Background: While many factors contribute to pulmonary exacerbations (PEX) ofin individuals with cystic fibrosis (CF), some studies suggest race and ethnicity may lead to disparities in hospitalizations. The impact of these potential disparities has not been well studied in the American Indian/Alaska Native (AI/AN) population. The objective of this study was to determine if AI/AN identity is associated with higher odds of experiencing hospitalization or home IV due to a PEX) when controlling for sociodemographic factors and clinical parameters.

Methods: This retrospective study utilized CF Registry data of non-Hispanic White and AI/AN individuals (0-19 years) seen at the Tulsa and OKC CF Centers in 2023. Data included demographics, health status, insurance type, distance and number of visits to the CF center. The best quarterly anthropometric and lung function measurements were used to calculate annual averages. Descriptive statistics, Wilcoxon Rank Sum tests and chi-square tests were performed to assess differences between the ethnoracial groups. Finally, logistic regression was performed to determine if Indigenous identity was associated with greater odds of hospitalization after controlling for child demographic factors and potential barriers/facilitators to care. The threshold for statistical significance was .05.

Results: Of the 174 individuals assessed 71.3% (n=124) were non-Hispanic White. The remaining 28.7% (n=50) were AI/AN alone or in combination with another race/ethnicity. There was a notable difference in individuals with hospitalizations/home IV treatments due to PEX between the AI/AN (n=11, 22%) and White (n=9, 7.3%) groups (X2(1)=7.6120, p=.006). When assessing differences between the non-Hispanic White and AI/AN groups, regardless of hospitalization, a statistically significant difference in the median distance between a home zip code and the CF Care Center was noted (Table 1). The median miles between a home zip code and care center were higher for AI/AN children (Median = 65.35 miles, IQR: 24.95 – 116) than their non-Hispanic White peers (Median = 24.95 miles; IQR: 17.95 – 92.9; z = -2.998 p = .0027). After controlling for all covariates of interest, AI/AN children had 3.71 higher odds (95%CI: 1.29 – 10.67) of experiencing at least one hospitalization or home IV due to PEX compared to their non-Hispanic White peers (Figure 1).

Conclusion: AI/AN children in this sample had significantly higher odds of experiencing at least one hospitalization or home IV due to pulmonary exacerbation compared to their non-Hispanic White peers. Larger studies are needed to validate these findings and identify reasons for health disparities affecting the AI/AN CF community.