Black Patients with Cirrhosis Have Longer Length of Stay and Higher Mortality When Hospitalized
1ACS Clinical Scholar, Chicago, IL, 2Transplant Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
Meeting: 2021 American Transplant Congress
Abstract number: 312
Keywords: African-American, Length of stay, Liver, Outcome
Topic: Clinical Science » Organ Inclusive » Non-Organ Specific: Disparities to Outcome and Access to Healthcare
Session Information
Session Name: Disparities in Access and Machine Learning Outcomes in Solid Organ Transplantation
Session Type: Rapid Fire Oral Abstract
Date: Tuesday, June 8, 2021
Session Time: 4:30pm-5:30pm
Presentation Time: 4:45pm-4:50pm
Location: Virtual
*Purpose: Black patients with cirrhosis have been shown to have higher liver-related mortality compared to White patients. However, little knowledge exists about racial differences related to length of stay and in-hospital mortality at 60 days in patients who are hospitalized for cirrhosis. To this end, we aim to characterize the LOS among hospitalized patients with compensated vs. decompensated cirrhosis stratified by race in the United States.
*Methods: A retrospective review of adult (>18 yrs) patients with cirrhosis was performed using the Nationwide Inpatient Sample data from 2010-2014. Validated ICD/CPT algorithms were used to identify cirrhosis and related complications (HE, SBP, ascites, GIB, HRS, HPS). Descriptive analysis and cox regression analysis were performed and dichotomized by race (White vs Black) for outcomes (LOS, In-hospital mortality).
*Results: Between 2010-2014, 879,216 hospitalizations were observed in patients with cirrhosis for a total of 5,674,320 total hospitalization days. The mean age was 62±14.8, 42.3% (N=371691) were female, 68.5% were White, 11.7% Black, 13.9% Hispanic, and 5.9% Other. 51.7% were insured with Medicare, 18.1% Medicaid, 19.7% private, 6.1% self-pay (Table 1). Clinically significant differences between Blacks and Whites were observed for HCV (31% vs 19%), Medicaid (15% vs 21%) and Private (15% vs 21%). 434,712 patients (52.8%) had decompensated cirrhosis (31.7% HE, 2.7% SBP, 24.7% ascites, 4.5% GIB, 3.5% HRS) and 3.6% had HCC. Patients with cirrhosis had a mean of 7.0 (3.1) chronic conditions. In-hospital mortality in Whites was 5.9% compared to 6.7% in Blacks (p<0.001). The median LOS was 4 (2-7) days for Whites and 5 (3-9) days for Blacks (p<0.001). Survival in Whites was 8% increased to Blacks (HR 1.08, 1.05-1.18) (Figure 1).
*Conclusions: In a national in-patient cohort sample, Black patients with cirrhosis have longer hospitalizations at baseline. Black patients in decompensated cirrhosis have lower survival than White patients.
To cite this abstract in AMA style:
Thomas A, Simpson D, Ladner DP, Berkowitz R. Black Patients with Cirrhosis Have Longer Length of Stay and Higher Mortality When Hospitalized [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/black-patients-with-cirrhosis-have-longer-length-of-stay-and-higher-mortality-when-hospitalized/. Accessed May 16, 2025.« Back to 2021 American Transplant Congress