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 17 February 2018

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News

Racial disparities in the management of hospitalized cirrhosis patients

The latest issue of Hepatology finds racial disparities in the management of hospitalized patients with cirrhosis and complications of portal hypertension.

News image

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Complications of portal hypertension is a harbinger of decompensated cirrhosis and warrants consideration for liver transplantation.

Racial disparities in liver transplantation have been reported.

Dr Paul Thuluvath and colleagues from Baltimore characterized these disparities in the performing of surgical and endoscopic procedures among hospitalized patients with complications of portal hypertension.

The team queried the Nationwide Inpatient Sample from 1998 to 2003 to identify patients with cirrhosis and complications of portal hypertension.

Logistic regression controlling for confounders was used to evaluate race as a predictor of undergoing a portosystemic shunt.

The research team also evaluated whether race predicted liver transplantation, and dying in the hospital.

The odds ratio of death for African Americans was 1.7 compared to whites
Hepatology

The researchers found that compared with whites, the adjusted odds ratio of receiving a portosystemic shunt was 0.4 for African Americans.

The adjusted odds ratio for receiving portosystemic shunt was 0.7 for Hispanics.

The team noted that African Americans with variceal bleeding were more likely to have endoscopic variceal hemostasis delayed more than 24 hours after admission.

The research team found that the adjusted odds ratios of undergoing liver transplantation were 0.3 for African Americans.

For Hispanics, that adjusted odds ratio of undergoing liver transplantation was 0.5.

Compared to whites, African Americans experienced higher in-hospital mortality, whereas Hispanics had a lower risk of death.

The team observed that among variceal bleeders, the odds ratio of death for African Americans was 1.7 compared to whites.

Dr Thuluvath's team concluded, "African Americans and Hispanics hospitalized for complications of portal hypertension were less likely to undergo a palliative shunt or liver transplantation than whites."

"This may contribute to the higher in-hospital mortality of African Americans".

"Further studies are warranted to elucidate the mechanisms of these exploratory findings."

Hepatology 2007:45(5): 1282-9
16 May 2007

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