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

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dc.contributor.authorSingal, Ashwani K.
dc.contributor.authorKuo, Yong-Fang
dc.contributor.authorArab, Juan P.
dc.contributor.authorBataller, Ramon
dc.date.accessioned2025-01-20T21:07:55Z
dc.date.available2025-01-20T21:07:55Z
dc.date.issued2022
dc.description.abstractBackground 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 liver 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/ethnicity 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 defined 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 observed 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 admissions, 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.
dc.fuente.origenWOS
dc.identifier.doi10.14218/JCTH.2021.00227
dc.identifier.eissn2310-8819
dc.identifier.issn2225-0719
dc.identifier.urihttps://doi.org/10.14218/JCTH.2021.00227
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93445
dc.identifier.wosidWOS:000792950300001
dc.issue.numero3
dc.language.isoen
dc.pagina.final404
dc.pagina.inicio398
dc.revistaJournal of clinical and translational hepatology
dc.rightsacceso restringido
dc.subjectAmerican Indians
dc.subjectAlaska Natives
dc.subjectNative Americans
dc.subjectHealthcare burden
dc.subjectEpidemiology
dc.subjectMagnitude
dc.subjectTransplant
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRacial and Health Disparities among Cirrhosis-related Hospitalizations in the USA
dc.typeartículo
dc.volumen10
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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