P2907 - Racial Disparities in Autoimmune Hepatitis - A Nationwide Inpatient Sample Analysis

Manasa Ginjupalli, MBBS, MD¹, Vikash Kumar, MD², Jayalekshmi Jayakumar, MBBS, MD³, Anuj R. Sharma, MBBS⁴, Saigopal R. Gujjula, MD⁴, Sunny Kumar, MD⁵, Amelia Panjwani, BSc⁶, Aakash Aakash, MD⁷, Gautam Maddineni, MD⁸, Aalam Sohal, MD^9
1The Brooklyn Hospital Center, New York, NY; ²Creighton University School of Medicine, Brooklyn, NY; ³The Brooklyn Hospital Center, Brooklyn, NY; ⁴Brooklyn Hospital Center, Brooklyn, NY; ⁵The Wright Center for GME, Scranton, PA; ⁶St. George's University School of Medicine, Brooklyn, NY; ⁷Florida State University Cape Coral Hospital, Cape Coral, FL; ⁸Florida State University, Cape Coral, FL; ⁹Creighton University School of Medicine, Seattle, WA

Introduction: Autoimmune hepatitis [AH] is a progressive, chronic necroinflammatory liver disorder of unknown cause. It commonly occurs in genetically predisposed individuals when a trigger like virus or environmental factors leads to a T cell mediated autoimmune response against liver cell antigens. There have been various studies establishing its variable occurrence, clinical phenotypes and outcomes, highlighting the prevalence of racial disparities in AH. In this study we tried to establish the racial disparities affecting hospitalization outcomes of AH in a large population using the National Inpatient Sample database.

Methods: We investigated National Inpatient Sample Database 2016 -2020 and used ICD-10 codes to find all the hospitalized individuals with AH. We studied various patient and hospitalization characteristics including type of admission, type of disposition and length of stay. Race was stratified to whites, blacks, hispanics and others. Multivariate regression was used to analyze the impact of race on in-hospital outcomes and resource utilization of AH after adjusting for age, gender, insurance, location, hospital characteristics and Charlson comorbidity index.

Results: A total of 153,605 AH hospitalizations were identified of which majority were Whites [Table 1]. Mean age of AH hospitalizations was 58.17 years of which 77.9% were females. Irrespective of race, majority admissions were non-elective to urban teaching hospitals with large bed-size and had a length of stay longer than seven days. Majority were discharged home (60.58% whites, 63.55% blacks, 69.1% hispanics) followed by facility/home with home care (35.87% whites, 32.77% blacks, 26.14% hispanics). Mortality was 3.55% in whites, 3.68% in blacks and 4.75% in hispanics. Multivariate analysis was performed and showed a statistically significant increase in discharge to facility/home with home care among Blacks and Native Americans compared to their white counterparts. Resource utilization was higher in the majority of the racial groups when compared to their white counterparts [Table 1].

Discussion: Our findings reveal statistically significant disparities in hospitalization outcomes among different racial groups with AH, suggesting the need for tailored interventions. Implementing targeted treatments and customized social support services for various racial demographics could enhance in-hospital outcomes, but further investigation is required to confirm causality.


Disclosures:


Manasa Ginjupalli, MBBS, MD¹, Vikash Kumar, MD², Jayalekshmi Jayakumar, MBBS, MD³, Anuj R. Sharma, MBBS⁴, Saigopal R. Gujjula, MD⁴, Sunny Kumar, MD⁵, Amelia Panjwani, BSc⁶, Aakash Aakash, MD⁷, Gautam Maddineni, MD⁸, Aalam Sohal, MD⁹. P2907 - Racial Disparities in Autoimmune Hepatitis - A Nationwide Inpatient Sample Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.