P1132 - In-Hospital Outcomes in Acute Decompensated Liver Failure Patients With and Without Systemic Lupus Erythematosus: A Three-Year Retrospective Review

Oluwatayo J. Awolumate, MD¹, Doris Akolbire, MD¹, Adebolanle Ayinde, MD, MPH², Pratiksha Moliya, MD³, Ikechukwu E. Eze, MD, MPH¹, Amro Abdellatief, MD¹, Adeyinka O. Laiyemo, MD, MPH¹, Angesom Kibreab, MD¹, Farshad Aduli, MD^1
1Howard University Hospital, Washington, DC; ²CHRISTUS Health | Texas A&M School of Medicine, Longview, TX; ³Jamaica Hospital Medical Center, Edison, NJ

Introduction: Acute decompensated liver failure (ADLF) presents a significant challenge, with mortality rates ranging from 30% to 50%. It is characterized by a sudden decline in liver function, leading to multisystemic complications. Systemic Lupus Erythematosus (SLE), an autoimmune disorder, can coexist and complicate ADLF management. Despite separate studies on SLE and ADLF outcomes, little data exists on whether the presence of SLE affects the outcome of patients with ADLF. This study aims to bridge that gap.

Methods: We reviewed the Nationwide Inpatient Sample (NIS) data for patients managed for acute decompensated liver disease from January 1, 2018, to December 31, 2020. Patients were divided into two groups based on SLE status (confirmed SLE diagnosis or no SLE present). We assessed two primary outcomes: mortality and length of stay (LOS). Secondary outcomes examined include gastrointestinal bleeding and spontaneous bacterial peritonitis (SBP). Patient characteristics, including age, sex, race, household income, insurance, hospital size, and comorbidities. We utilized weighted multivariable models to adjust for confounding variables.

Results: We examined a total of 43,831 patients admitted with ADLF, of which 240 (0.55%) had SLE and 43,591 (99.45%) did not. The study found that mortality in patients with SLE is lower than in those without SLE but not statistically significant (aOR = 0.68, 95% CI: 0.37–1.24, p = 0.209). Among those patients with SLE, black patients are more likely to die from ADLF compared to white patients (aOR = 1.28, 95% CI: 1.13–1.46, p = 0.000). Also, mortality from ADLF in SLE patients was significantly higher in urban teaching hospitals when compared to rural hospitals (aOR = 1.29, 95% CI: 1.08–1.53, p = 0.004). There was no significant difference in LOS, GI bleeding, or SBP between patients with and without SLE (aOR = 0.79, 95% CI: 0.32-1.95, p = 0.612), (aOR = 1.16, 95% CI: 0.51–2.62, p=0.721), or (aOR = 0.52, 95% CI: 0.19–1.40, p=0.199), respectively.

Discussion: The results of our study revealed no significant difference in mortality between the two groups. However, among patients with SLE, there was an increase in mortality in black and Hispanic patients, potentially due to health disparities in access to care. Mortality was also higher among SLE patients in urban teaching hospitals, likely due to their tertiary status and care of more complex patients. There was also no significant difference in the other outcomes assessed in both groups.


Disclosures:


Oluwatayo J. Awolumate, MD¹, Doris Akolbire, MD¹, Adebolanle Ayinde, MD, MPH², Pratiksha Moliya, MD³, Ikechukwu E. Eze, MD, MPH¹, Amro Abdellatief, MD¹, Adeyinka O. Laiyemo, MD, MPH¹, Angesom Kibreab, MD¹, Farshad Aduli, MD¹. P1132 - In-Hospital Outcomes in Acute Decompensated Liver Failure Patients With and Without Systemic Lupus Erythematosus: A Three-Year Retrospective Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.