P4594 - Ethnicity's Role in Acute Liver Failure Outcomes: A Comprehensive Analysis in the United States

Kibwey Peterkin, MD¹, Carina-Leigh Lezama, MD², Shani Mc Lean, MD¹, Abiolah Telesford, MD¹, Jamal Perry, MD¹, Chidiebele Emmanuel Omaliko, MD¹, Ifeanyi Uche, MD^1
1One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY; ²Peterborough City Hospital, Peterborough, England, United Kingdom

Introduction: In the realm of acute liver failure (ALF), where sudden coagulopathy and encephalopathy create uncertainty, hepatotoxic injury profoundly impacts morbidity and mortality. This study delves into racial disparities in ALF outcomes in the United States, aiming to illuminate overlooked healthcare inequities and enhance management strategies.

Methods: We analyzed data from the 2017-2020 National Inpatient Sample database to study acute liver failure (ALF) patients. We included adult patients without chronic liver disease, categorizing them into six racial groups. Our aim was to examine racial disparities compared to White patients and their impact on ALF outcomes, including in-hospital mortality, length of stay (LOS), hospital charges (THC), intensive care unit (ICU) admission, sepsis, septic shock, and liver transplant receipt. Multivariable regression analyses were performed, adjusting for patient and hospital characteristics.

Results: The study included 33,405 patients with acute liver failure (ALF), predominantly White (66.43%), followed by Black (9.45%), Hispanic (16.46%), Asian/Pacific Islander (2.23%), Native American (2.28%), and Other (3.14%). Compared to Whites, other racial groups, except Asian/Pacific Islanders, were younger and more often male. Hispanics showed lower odds of in-hospital mortality (adjusted odds ratio [aOR] 0.86, 95% CI 0.75-0.99; P=0.03) and shorter LOS (-0.32 days, 95% CI -0.60 to -0.04; P=0.03). Hispanics, Asian/Pacific Islanders, and Others had increased THC [$7,559.21 (95% CI 2377.49-12340.93; P< 0.01), $24,854.86 (95% CI 6070.11-43639.64; P=0.01), $29,883.10 (95% CI 7698.63-52067.57; P< 0.01), respectively], while Native Americans had reduced THC [$20,131.56 (95% CI -28421.78 to -11841.34; P=0.00)]. Blacks and Asian/Pacific Islanders had increased odds of sepsis [aOR 1.48 (95% CI 1.16-1.90; P< 0.01), aOR 1.73 (95% CI 1.14-2.62; P=0.01), respectively]. Blacks also had increased odds of septic shock, aOR 1.25 (95% CI 1-1.58; P=0.050). No significant differences were found in ICU care or liver transplant rates based on race.

Discussion: The study indicates racial disparities in clinical outcomes and healthcare utilization among ALF patients. Although Hispanic patients generally fared well in mortality and LOS, disparities persisted in areas like sepsis development and total hospital charges among minority racial groups. Addressing these gaps may necessitate targeted interventions to enhance healthcare access, quality, and outcomes for minority populations.


Disclosures:


Kibwey Peterkin, MD¹, Carina-Leigh Lezama, MD², Shani Mc Lean, MD¹, Abiolah Telesford, MD¹, Jamal Perry, MD¹, Chidiebele Emmanuel Omaliko, MD¹, Ifeanyi Uche, MD¹. P4594 - Ethnicity's Role in Acute Liver Failure Outcomes: A Comprehensive Analysis in the United States, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.