首页|Racial and Health Disparities among Cirrhosis-related Hospitalizations in the USA

Racial and Health Disparities among Cirrhosis-related Hospitalizations in the USA

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
  • 维普
Background and Aims: Alcohol-associated liver disease (ALD) is the most common cause of advanced liver disease worldwide, including in the USA. Alcohol use and cirrhosis mortality is higher in American Indian/Alaska Native (AI/AN) compared to Whites. Data are scanty on ALD as a liv-er disease etiology in AI/AN compared to other races and ethnicities. Methods: The National Inpatient Sample on 199,748 cirrhosis-related hospitalizations, 14,241 (2,893 AI/AN, 2,893 Whites, 2,882 Blacks, 2,879 Hispanics, and 2,694 Asians or other races) matched 1:1 for race/ethnic-ity on demographics, insurance, and income quartile of the residence zip code analyzed. Results: After controlling for geographic location and hospital type, odds ratio (OR) and 95％ confidence interval (CI) for ALD as cirrhosis etiology was higher among admissions in AI/AN vs. Whites [1.55 (1.37–1.75)], vs. Blacks [1.87 (1.65–2.11)], vs. Hispanic [1.89 (1.68–2.13)] and Asians/other races [2.24 (1.98–2.53)]. OR was also higher for AI/AN vs. all other races for alcohol-associated hepatitis (AH) as one of the discharge diagnoses. The findings were similar in a subgroup of 4,649 admissions with decompensated cirrhosis and in a cohort of 350 admissions with acute-on-chronic liver failure as de-fined by EASL-CLIF criteria. Alcohol use disorder diagnosis was present in 38％ of admissions in AI/AN vs. 24–30％ in other races, p<0.001. A total of 838 (5.9％) admissions were associated with in-hospital mortality. OR (95％ CI) for in-hospital mortality in AI/AN individuals was 34％ reduced vs. Blacks [0.66 (0.51–0.84)], but no difference was ob-served on comparison with other races. Conclusions: ALD, including AH, is the most common etiology among cirrhosis-related hospitalizations in the USA among AI/AN individuals. In-hospital mortality was observed in about 6％ of admis-sions, which was higher for Blacks and similar in other races compared to admissions for AI/AN. Public health policies should be implemented to reduce the burden of advanced ALD among AI/AN individuals.

American IndiansAlaska NativesNative AmericansHealthcare burdenEpidemiologyMagnitudeTransplant

Ashwani K.Singal、Yong-Fang Kuo、Juan P.Arab、Ramon Bataller

展开 >

Department of Medicine,University of SD Sanford School of Medicine,Sioux Falls,SD,USA

Division of Transplant Hepa-tology,Avera Transplant Institute,Sioux Falls,SD,USA

Department of Biostatistics,University of Texas Medical Branch at Galveston,Galveston,TX,USA

Departamento de Gastroenterología,Escuela de Medicina,Pontificia Universidad Católica de Chile,Santiago,Chile

Division of Gastroenterology and Hepatology,University of Pittsburgh Medical Center,Pittsburgh,PA,USA

展开 >

2022

10.14218/JCTH.2021.00227

临床与转化肝病杂志(英文版)

临床与转化肝病杂志(英文版)

ISSN：
年,卷(期)：2022.10(3)
  • 36